=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700978681
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMA ALEXIS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2006
-----------------------------------------------------
Last Update Date | 04/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 49 MURRAY ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10007-2250
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-729-1283
-----------------------------------------------------
Fax | 866-419-6235
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 49 MURRAY ST
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10007-2250
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-729-1283
-----------------------------------------------------
Fax | 866-419-6235
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0201X
-----------------------------------------------------
Taxonomy Name | Pediatric Allergy/Immunology Physician
-----------------------------------------------------
License Number | 241074
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 241074
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------