Provider Demographics
NPI:1841241148
Name:DAVIES, ALEXANDRA (RPA)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:
Last Name:DAVIES
Suffix:
Gender:F
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6600
Mailing Address - Street 2:18969 US ROUTE 11
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-6600
Mailing Address - Country:US
Mailing Address - Phone:315-782-4391
Mailing Address - Fax:315-788-8319
Practice Address - Street 1:18969 US ROUTE 11
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-5320
Practice Address - Country:US
Practice Address - Phone:315-782-4391
Practice Address - Fax:315-788-8319
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008464-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant