Provider Demographics
NPI:1720744741
Name:FARBSTEIN, ALEXANDRA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:FARBSTEIN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 482 BOX 2732
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362-0028
Mailing Address - Country:US
Mailing Address - Phone:219-743-4936
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:
Practice Address - City:CHATAN
Practice Address - State:OKINAWA
Practice Address - Zip Code:9040103
Practice Address - Country:JP
Practice Address - Phone:098-971-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-14
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305213095225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist