Healthcare Provider Details

I. General information

NPI: 1619868809
Provider Name (Legal Business Name): ALEXANDRA SPRAUER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 E BROADWAY RD
MESA AZ
85206-1346
US

IV. Provider business mailing address

36 TINKERTOWN RD
PLEASANT VALLEY NY
12569-7200
US

V. Phone/Fax

Practice location:
  • Phone: 480-396-9922
  • Fax:
Mailing address:
  • Phone: 845-594-7537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-034994
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number054343
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: