Provider Demographics
NPI:1699037465
Name:BARNSWELLBUFORD, ALEXIA
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:BARNSWELLBUFORD
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 1:15934 RIVERSIDE DR W
Mailing Address - Street 2:APT. 6B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1014
Mailing Address - Country:US
Mailing Address - Phone:917-804-3480
Mailing Address - Fax:
Practice Address - Street 1:15934 RIVERSIDE DR W
Practice Address - Street 2:APT. 6B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1014
Practice Address - Country:US
Practice Address - Phone:917-804-3480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist