Provider Demographics
NPI:1255594230
Name:COLVIN, ALEXIS CHIANG (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:CHIANG
Last Name:COLVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 E. 98TH ST
Mailing Address - Street 2:BOX 1188
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-1815
Mailing Address - Fax:212-241-5965
Practice Address - Street 1:5 E. 98TH ST
Practice Address - Street 2:BOX 1188
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-1815
Practice Address - Fax:212-241-5965
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236322-1207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine