NPI Code Details Logo

NPI 1760344618

NPI 1760344618 : ALEXANDRA EBOL : NEW YORK, NY

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1760344618
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    ALEXANDRA EBOL
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/01/2025
-----------------------------------------------------
    Last Update Date     |    12/01/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    300 E 66TH ST 
-----------------------------------------------------
    City                 |    NEW YORK
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    10065-6800
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    646-888-6898
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    300 E 66TH ST 
-----------------------------------------------------
    City                 |    NEW YORK
-----------------------------------------------------
    State                |    NY
-----------------------------------------------------
    Zip                  |    10065-6800
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    390200000X
-----------------------------------------------------
    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
    License Number       |    26NR19457000
-----------------------------------------------------
    License Number State |    NJ
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.