Provider Demographics
NPI:1437552585
Name:KOCHEL, ALEXANDRA M (DPT, PT)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:M
Last Name:KOCHEL
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:M
Other - Last Name:SCHOENER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, PT
Mailing Address - Street 1:1 CREDIT UNION WAY
Mailing Address - Street 2:FL. 3
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:300 ELMWOOD ST
Practice Address - Street 2:
Practice Address - City:N ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-1304
Practice Address - Country:US
Practice Address - Phone:508-695-2280
Practice Address - Fax:508-695-2298
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023988225100000X
MA22695225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110120615AMedicaid
MA4172419OtherAETNA
MA441819OtherTUFTS