Provider Demographics
NPI:1912468133
Name:COSGRO, ALEXA MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:MARIE
Last Name:COSGRO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 S PERU ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-4706
Mailing Address - Country:US
Mailing Address - Phone:518-563-7777
Mailing Address - Fax:518-563-7770
Practice Address - Street 1:135 S PERU ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-4706
Practice Address - Country:US
Practice Address - Phone:518-563-7777
Practice Address - Fax:518-563-7770
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist