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General NPI Number Information
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NPI Number | 1962824987
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Entity Type | Individual
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Provider Name | AISHA ALEXIS LMSW
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Gender | Female
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 4401 BRONX BLVD
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City | BRONX
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State | NY
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Zip | 10470-1407
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Country | US
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Telephone | 718-304-7029
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Fax | 718-304-7081
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Provider Business Mailing Address
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Address Line | 2074 WALLACE AVE APT 706
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City | BRONX
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State | NY
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Zip | 10462-2540
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Country | US
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Telephone | 646-319-9955
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 083271
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License Number State | NY
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