Provider Demographics
NPI:1326410473
Name:CRISAFI, ALEXIS (NP)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CRISAFI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 OLD FORD RD
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2660
Mailing Address - Country:US
Mailing Address - Phone:631-235-4871
Mailing Address - Fax:
Practice Address - Street 1:2 SUMMIT CT STE 202
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-4318
Practice Address - Country:US
Practice Address - Phone:845-897-0009
Practice Address - Fax:631-235-4871
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4019343363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health