Healthcare Provider Details

I. General information

NPI: 1013659465
Provider Name (Legal Business Name): ALEXA RYANN LEIB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 WESTCHESTER AVE
WEST HARRISON NY
10604-2901
US

IV. Provider business mailing address

12 FOX RIDGE RD
ARMONK NY
10504-2216
US

V. Phone/Fax

Practice location:
  • Phone: 914-682-0700
  • Fax:
Mailing address:
  • Phone: 646-265-8807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number346481
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: