Provider Demographics
NPI:1639335714
Name:JUWAH, ALEXANDER AZUKA (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:AZUKA
Last Name:JUWAH
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 1:100 WASHINGTON STREET
Mailing Address - Street 2:ELMIRA PSYCHIATRIC CENTER
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901
Mailing Address - Country:US
Mailing Address - Phone:607-737-4841
Mailing Address - Fax:
Practice Address - Street 1:100 WASHINGTON STREET
Practice Address - Street 2:ELMIRA PSYCHIATRIC CENTER
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901
Practice Address - Country:US
Practice Address - Phone:607-737-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP637182084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry