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NPI Code Detail

MEDICARE: JEBU ALEXANDER PT

MEDICARE: JEBU ALEXANDER PT
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
1225100000XPhysical Therapist039908NY

General Provider Information

NPI Number : 1659730364
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEBU ALEXANDER PT
Provider Business Mailing Address
First Line : 4 BALSAM CT
Second Line :
City : NEW CITY
State : NY
Zip : 10956-6718
Country : US
Telephone Number : 914-844-6468
Fax Number :
Provider Business Practice Location Address
First Line : 171 KINGS HWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-1023
Country : US
Telephone Number : 516-503-9396
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2016
Last Update Date : 08/18/2025

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