Healthcare Provider Details

I. General information

NPI: 1801735360
Provider Name (Legal Business Name): ALEXANDRA TRUZOG PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 JEROME AVE
BRONX NY
10468-1106
US

IV. Provider business mailing address

8406 109TH ST APT 8D
RICHMOND HILL NY
11418-1262
US

V. Phone/Fax

Practice location:
  • Phone: 718-728-8476
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number009902-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: