Provider Demographics
NPI:1568007664
Name:BROSKY, ALEXANDRA RENEE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RENEE
Last Name:BROSKY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 DAVES WAY STE 300
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:PA
Mailing Address - Zip Code:19526-1413
Mailing Address - Country:US
Mailing Address - Phone:610-628-7204
Mailing Address - Fax:610-628-7214
Practice Address - Street 1:9 DAVES WAY STE 300
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526-1413
Practice Address - Country:US
Practice Address - Phone:610-628-7204
Practice Address - Fax:610-724-7214
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT027610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist