=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639032808
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXA WARE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/04/2025
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 E 70TH ST APT 2C
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10021-8689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-210-6742
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1424 146TH ST
-----------------------------------------------------
City | WHITESTONE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11357-2436
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-210-6742
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 407523
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------