Provider Demographics
NPI:1023872629
Name:ALEXIS, SABINE (PT)
Entity type:Individual
Prefix:
First Name:SABINE
Middle Name:
Last Name:ALEXIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 JACOBY ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3055
Mailing Address - Country:US
Mailing Address - Phone:862-888-6751
Mailing Address - Fax:855-678-8887
Practice Address - Street 1:135 JACOBY ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3055
Practice Address - Country:US
Practice Address - Phone:862-888-6751
Practice Address - Fax:855-678-8887
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA02184900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist