Alexandra Antonelli
Individual provider Active NPI Specialist · Deer Park, NY
NPI 1134816283 · NPPES record last updated Apr 19, 2023
Key facts
- NPI
- 1134816283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 49 Byway Dr
Deer Park, NY 11729-6204 - Phone
- (631) 357-1343
- NPI assigned
- Apr 19, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NY | Yes |
Addresses
Primary practice location
49 Byway Dr
Deer Park, NY 11729-6204
Mailing address
49 Byway Dr
Deer Park, NY 11729-6204
Phone (631) 357-1343
Other providers in Deer Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.