Provider Demographics
NPI:1629684956
Name:SPOSETTI, ALEXIS MECRAY
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MECRAY
Last Name:SPOSETTI
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 1:147 KRAUSER RD
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-1502
Mailing Address - Country:US
Mailing Address - Phone:484-888-3036
Mailing Address - Fax:
Practice Address - Street 1:1200 TEL HAI CIR
Practice Address - Street 2:
Practice Address - City:HONEY BROOK
Practice Address - State:PA
Practice Address - Zip Code:19344-1271
Practice Address - Country:US
Practice Address - Phone:484-796-4261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002640L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation