Most Relevant Information
Provider Data
| NPI Number: | 1003463829 |
| Provider Name: | ALIXANDRA LIN PETERSEN DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 044755 |
Most Important Dates
| Enumeration Date: | 08/26/2019 |
| Last Updated: | 08/26/2019 |
Provider Practice Location
462 1ST AVE
NEW YORK
NY
100169196
Practice Location Phone/Fax
| Phone: | 2125627059 |
| Fax: |
Provider Mailing Location
266 9TH ST # 1
BROOKLYN
NY
112153906
Provider Mailing Phone/Fax
| Phone: | 3475769915 |
| Fax: |