MEDICARE: ALEXIS CRISAFI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)	40401934	NY
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	40401934	NY

General Provider Information

NPI Number	:	1326417999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEXIS CRISAFI

Provider Business Mailing Address
First Line	:	1420 OLD FORD RD
Second Line	:
City	:	NEW PALTZ
State	:	NY
Zip	:	12561-2660
Country	:	US
Telephone Number	:	631-235-4871
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 OLD FORD RD
Second Line	:
City	:	NEW PALTZ
State	:	NY
Zip	:	12561-2660
Country	:	US
Telephone Number	:	631-235-4871
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	ALEXIS CRISAFI
Credential	:	RN, BSN, PMHNP
Telephone Number	:	631-235-4871

Provider Enumeration Date	:	09/24/2015
Last Update Date	:	09/24/2015

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Directions to “ALEXIS CRISAFI ” Practice Location

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