Healthcare Provider Details

I. General information

NPI: 1427207281
Provider Name (Legal Business Name): ALEXIS M CHESROW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE FL 3
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1415 TULANE AVE FL 3
NEW ORLEANS LA
70112-2600
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5271
  • Fax: 504-988-7655
Mailing address:
  • Phone: 504-988-5271
  • Fax: 504-988-7655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number55261-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number036123327
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA108405
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number61996
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number61996
License Number StateAZ
# 6
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number334621
License Number StateLA
# 7
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number334621
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: