Healthcare Provider Details

I. General information

NPI: 1598544892
Provider Name (Legal Business Name): ALEXA MCGHEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 FRANKLIN AVE
GARDEN CITY NY
11530-2913
US

IV. Provider business mailing address

19 E OCEAN HEIGHTS AVE
LINWOOD NJ
08221-2121
US

V. Phone/Fax

Practice location:
  • Phone: 516-742-3404
  • Fax:
Mailing address:
  • Phone: 609-457-9017
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number23-P125013-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: