Provider Demographics
NPI:1629371901
Name:ALEXIS-JOHN, SHERON M
Entity Type:Individual
Prefix:MRS
First Name:SHERON
Middle Name:M
Last Name:ALEXIS-JOHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1226 E 56TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3330
Mailing Address - Country:US
Mailing Address - Phone:718-531-5068
Mailing Address - Fax:347-374-6017
Practice Address - Street 1:1226 E 56TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3330
Practice Address - Country:US
Practice Address - Phone:718-531-5068
Practice Address - Fax:347-374-6017
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013889-1225X00000X
FL12810225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist