Healthcare Provider Details

I. General information

NPI: 1396508818
Provider Name (Legal Business Name): ALEXANDRA LYN HITCHENS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2024
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1317 3RD AVE FL 9
NEW YORK NY
10021-2963
US

IV. Provider business mailing address

1635 E SELDON LN
PHOENIX AZ
85020-3307
US

V. Phone/Fax

Practice location:
  • Phone: 212-439-1596
  • Fax:
Mailing address:
  • Phone: 302-547-6564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number051838-01
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: