Provider Demographics
NPI:1366060923
Name:CHUPICK, ALEXA RAE (PA)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:RAE
Last Name:CHUPICK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 ASBURY WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-5463
Mailing Address - Country:US
Mailing Address - Phone:570-983-4413
Mailing Address - Fax:
Practice Address - Street 1:14610 S MILITARY TRL STE G3
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3801
Practice Address - Country:US
Practice Address - Phone:561-819-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2022-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical