Provider Demographics
NPI:1790512887
Name:URIA, ALEXIS (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:URIA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WESTCHESTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-3497
Mailing Address - Country:US
Mailing Address - Phone:914-517-8056
Mailing Address - Fax:914-948-0351
Practice Address - Street 1:4 WESTCHESTER PARK DR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-3497
Practice Address - Country:US
Practice Address - Phone:914-517-8056
Practice Address - Fax:914-948-0351
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7100363A00000X
NY363AM0700X
NY033110363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical