Provider Demographics
NPI:1538302310
Name:OLIVEROS, ALEXIS NOELLE (MD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:NOELLE
Last Name:OLIVEROS
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:50 DAYTON LN STE 202
Mailing Address - Street 2:THE WESTCHESTER MEDICAL PRACTICE PC
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2860
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:35 S RIVERSIDE AVE
Practice Address - Street 2:THE WESTCHESTER MEDICAL PRACTICE PC
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2653
Practice Address - Country:US
Practice Address - Phone:914-233-3005
Practice Address - Fax:914-207-1616
Is Sole Proprietor?:No
Enumeration Date:2009-04-09
Last Update Date:2022-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY265746207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400075709Medicare PIN