Healthcare Provider Details

I. General information

NPI: 1215714654
Provider Name (Legal Business Name): ALEXA F BERGMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALI FEIN

II. Dates (important events)

Enumeration Date: 09/11/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12311 PERRY HWY
WEXFORD PA
15090-8344
US

IV. Provider business mailing address

12311 PERRY HWY
WEXFORD PA
15090-8344
US

V. Phone/Fax

Practice location:
  • Phone: 878-332-4387
  • Fax:
Mailing address:
  • Phone: 878-332-4387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberMA066327
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: