1578559050 NPI number — ALEXIS HARVEY MD

Table of content: ALEXIS HARVEY MD (NPI 1578559050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578559050 NPI number — ALEXIS HARVEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARVEY
Provider First Name:
ALEXIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578559050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1865 ROUTE 70 E STE 220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-2005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-429-1519
Provider Business Mailing Address Fax Number:
239-931-7385

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1865 ROUTE 70 E STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08003-2005
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-429-1519
Provider Business Practice Location Address Fax Number:
856-427-2933
Provider Enumeration Date:
09/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0001X , with the licence number:  25MA05296000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01000393204 . This is a "AMERICHOICE-WIILINGBORO #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2095306000 . This is a "AMERIHEALTH PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 60014846 . This is a "HORIZON NJ HEALTH PROV. #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 80456 . This is a "AMERIGROUP PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 824145 . This is a "FIRST HEALTH/CCN PROV. #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000393202 . This is a "AMERICHOICE-VOORHEES #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2K7310 . This is a "HEALTH NET PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 39907 . This is a "UNIV. HLTH PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4099457 . This is a "GHI PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0911197 . This is a "CIGNA PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5449201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: BNS020 . This is a "OXFORD HEALTH PROVIDER #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000393206 . This is a "AMERICHOICE- HAMMONTON" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3644700 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00179709 . This is a "RAILROAD MCARE PROV. #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 01000393203 . This is a "AMERICHOICE-WOODBURY #" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5448201 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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