Basic Information
| Provider Information | |||||||||
| NPI: | 1578066395 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TURBIN | ||||||||
| FirstName: | ALEXIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8001 ROOSEVELT BLVD STE 307 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191523039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2677311333 | ||||||||
| FaxNumber: | 2154562386 | ||||||||
| Practice Location | |||||||||
| Address1: | 8001 ROOSEVELT BLVD STE 307 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2677311333 | ||||||||
| FaxNumber: | 3024070334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2018 | ||||||||
| LastUpdateDate: | 02/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | OA004402 | PA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | MA059647 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.