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General NPI Number Information
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NPI Number | 1356037873
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Entity Type | Individual
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Provider Name | ALIX JOSEPH LEGER
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Gender | Male
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 1000 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1000
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Country | US
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Telephone | 718-749-2346
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Fax |
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Provider Business Mailing Address
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Address Line | 585 SCHENECTADY AVE
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City | BROOKLYN
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State | NY
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Zip | 11203-1822
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 029806
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License Number State | NY
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