Healthcare Provider Details

I. General information

NPI: 1336508886
Provider Name (Legal Business Name): ALEXIS LORI CLAUSS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXIS LORI MALLOY NP

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

259 1ST ST
MINEOLA NY
11501-3957
US

IV. Provider business mailing address

333 W BROADWAY
LONG BEACH NY
11561-3936
US

V. Phone/Fax

Practice location:
  • Phone: 516-663-6923
  • Fax: 609-291-5507
Mailing address:
  • Phone: 609-781-4116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number343863
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR16041100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: