Provider Demographics
NPI:1770289001
Name:COX, ALEXANDRA ROSE (LMT)
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:ROSE
Last Name:COX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HORTON CT
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-1107
Mailing Address - Country:US
Mailing Address - Phone:631-902-8723
Mailing Address - Fax:
Practice Address - Street 1:984 N BROADWAY STE L08
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1319
Practice Address - Country:US
Practice Address - Phone:914-207-8270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024682225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist