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General NPI Number Information
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NPI Number | 1598631798
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Entity Type | Organization
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Legal Business Name | ALEXA REYNOSO-JIMENEZ
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Dates
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Enumeration Date | 10/14/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 15 SKYLINE DR
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City | HAWTHORNE
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State | NY
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Zip | 10532-2152
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Country | US
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Telephone | 914-347-5990
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Fax |
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Provider Business Mailing Address
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Address Line | 106 DEPEYSTER ST APT 2R
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City | SLEEPY HOLLOW
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State | NY
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Zip | 10591-2431
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Country | US
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Telephone | 914-386-4545
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Fax |
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Authorized Official
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Title or Position | TEACHER
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Name | ALEXA REYNOSO-JIMENEZ
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Credential |
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Telephone | 914-386-4545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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