Healthcare Provider Details

I. General information

NPI: 1235050410
Provider Name (Legal Business Name): ALEX MARSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 PRINCETON AVENUE EXT
CORNING NY
14830-1524
US

IV. Provider business mailing address

377 IMPERIAL AVE
PAINTED POST NY
14870-1442
US

V. Phone/Fax

Practice location:
  • Phone: 607-962-3148
  • Fax:
Mailing address:
  • Phone: 607-962-3148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number128834-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: