Provider Demographics
NPI:1639615529
Name:GARRAWAY, ALEXIS M
Entity Type:Individual
Prefix:MR
First Name:ALEXIS
Middle Name:M
Last Name:GARRAWAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 ROCKAWAY AVE
Mailing Address - Street 2:APT 16-C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4260
Mailing Address - Country:US
Mailing Address - Phone:646-597-0900
Mailing Address - Fax:718-228-5294
Practice Address - Street 1:216 ROCKAWAY AVE
Practice Address - Street 2:APT 16-C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-4260
Practice Address - Country:US
Practice Address - Phone:646-597-0900
Practice Address - Fax:718-228-5294
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health