Healthcare Provider Details

I. General information

NPI: 1700978681
Provider Name (Legal Business Name): AMA ALEXIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 04/03/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 MURRAY ST
NEW YORK NY
10007-2250
US

IV. Provider business mailing address

49 MURRAY ST
NEW YORK NY
10007-2250
US

V. Phone/Fax

Practice location:
  • Phone: 212-729-1283
  • Fax: 866-419-6235
Mailing address:
  • Phone: 212-729-1283
  • Fax: 866-419-6235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number241074
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number241074
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: