Provider Demographics
NPI:1497516223
Name:TABILE, ALEXA DOROTHY
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:DOROTHY
Last Name:TABILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 FALMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT SINAI
Mailing Address - State:NY
Mailing Address - Zip Code:11766-2724
Mailing Address - Country:US
Mailing Address - Phone:631-827-1609
Mailing Address - Fax:
Practice Address - Street 1:41 FALMOUTH DR
Practice Address - Street 2:
Practice Address - City:MOUNT SINAI
Practice Address - State:NY
Practice Address - Zip Code:11766-2724
Practice Address - Country:US
Practice Address - Phone:631-827-1609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer