Provider Demographics
NPI:1740778174
Name:FRIDSTEIN, ALEXIS LEIGH (MA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LEIGH
Last Name:FRIDSTEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ALLIE
Other - Middle Name:LEIGH
Other - Last Name:FRIDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:199 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-1301
Mailing Address - Country:US
Mailing Address - Phone:614-274-9500
Mailing Address - Fax:
Practice Address - Street 1:199 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-1301
Practice Address - Country:US
Practice Address - Phone:614-274-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-01
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker