Provider Demographics
NPI:1740433390
Name:ROSAND, ALEXIS M (MS)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIS
Middle Name:M
Last Name:ROSAND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:EAST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11730-1119
Mailing Address - Country:US
Mailing Address - Phone:631-224-2651
Mailing Address - Fax:
Practice Address - Street 1:18 JACKSON ST
Practice Address - Street 2:
Practice Address - City:EAST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11730-1119
Practice Address - Country:US
Practice Address - Phone:631-224-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014707-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist