Provider Demographics
NPI:1760931372
Name:TRUESDELL, ALEX
Entity Type:Individual
Prefix:MS
First Name:ALEX
Middle Name:
Last Name:TRUESDELL
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 1:313 W 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-6401
Mailing Address - Country:US
Mailing Address - Phone:212-904-1200
Mailing Address - Fax:212-904-1700
Practice Address - Street 1:313 W 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-6401
Practice Address - Country:US
Practice Address - Phone:212-904-1200
Practice Address - Fax:212-904-1700
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist