Healthcare Provider Details

I. General information

NPI: 1639246747
Provider Name (Legal Business Name): ALEXA B ADAMS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4872
US

IV. Provider business mailing address

535 E 70TH ST
NEW YORK NY
10021-4872
US

V. Phone/Fax

Practice location:
  • Phone: 212-774-2083
  • Fax: 212-774-7367
Mailing address:
  • Phone: 212-774-2083
  • Fax: 212-774-7367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number218561-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: