Provider Demographics
NPI:1790579746
Name:ISRAEL, ALEXANDRA AYA (MSOT, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:AYA
Last Name:ISRAEL
Suffix:
Gender:
Credentials:MSOT, OTR/L
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:AYA
Other - Last Name:PIERRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT, OTR/L
Mailing Address - Street 1:515 CHURCH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BOUND BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08805-1743
Mailing Address - Country:US
Mailing Address - Phone:732-377-9523
Mailing Address - Fax:
Practice Address - Street 1:515 CHURCH ST STE 3
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1743
Practice Address - Country:US
Practice Address - Phone:732-377-9523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01235400225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist