Provider Demographics
NPI:1922607027
Name:SIEGRIST, ALEXANDRA (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:SIEGRIST
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 SAINT MARKS PL APT 515
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-5182
Mailing Address - Country:US
Mailing Address - Phone:831-869-8922
Mailing Address - Fax:
Practice Address - Street 1:258 COURT STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231
Practice Address - Country:US
Practice Address - Phone:646-518-5560
Practice Address - Fax:212-379-2188
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2251X0800X
NYP107293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic