Provider Demographics
NPI:1578652921
Name:FLEURY, ALIX E (MD)
Entity Type:Individual
Prefix:
First Name:ALIX
Middle Name:E
Last Name:FLEURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SELWYN AVE
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7626
Mailing Address - Country:US
Mailing Address - Phone:718-960-2041
Mailing Address - Fax:718-960-2045
Practice Address - Street 1:1650 SELWYN AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7626
Practice Address - Country:US
Practice Address - Phone:718-960-2041
Practice Address - Fax:718-960-2045
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253440207Q00000X, 207W00000X
NY0253440207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist