Healthcare Provider Details

I. General information

NPI: 1578826418
Provider Name (Legal Business Name): ALEXA BETH FORMAN DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXA BETH FELDMAN DNP, FNP-BC

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E. 38TH ST 6TH FLOOR
NEW YORK NY
10016
US

IV. Provider business mailing address

333 E 38TH ST FL 6
NEW YORK NY
10016-2772
US

V. Phone/Fax

Practice location:
  • Phone: 646-501-7200
  • Fax:
Mailing address:
  • Phone: 516-672-1051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337145
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: