Provider Demographics
NPI:1265792014
Name:MACY, ALEXANDRA SARAH (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:SARAH
Last Name:MACY
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 1:4025 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3081
Mailing Address - Country:US
Mailing Address - Phone:153-826-6680
Mailing Address - Fax:
Practice Address - Street 1:4025 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-3081
Practice Address - Country:US
Practice Address - Phone:215-382-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1210712084P0800X
PAMD4524252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry