Provider Demographics
NPI:1598086472
Name:LEY, ALEXIS NICOLE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:NICOLE
Last Name:LEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:NICOLE
Other - Last Name:PREBIHILO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3000 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4472
Mailing Address - Country:US
Mailing Address - Phone:814-942-1166
Mailing Address - Fax:814-942-1169
Practice Address - Street 1:3000 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-4472
Practice Address - Country:US
Practice Address - Phone:814-942-1166
Practice Address - Fax:814-942-1169
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PASC006257213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program