Provider Demographics
NPI:1568880425
Name:ROSENBERG, ALEXA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 E 44TH ST
Mailing Address - Street 2:APARTMENT 3G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4336
Mailing Address - Country:US
Mailing Address - Phone:516-695-1774
Mailing Address - Fax:
Practice Address - Street 1:279 E 44TH ST
Practice Address - Street 2:APARTMENT 3G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4336
Practice Address - Country:US
Practice Address - Phone:516-695-1774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018735225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist