Active NPI
Edward Alexander, SI
- Specialist
- Brooklyn, NY
National Provider Identifier
1750524823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 21883
- Practice address
- 1662 Ocean Ave
Brooklyn, NY 11230-4905 - Phone
- (718) 677-4140
- NPI assigned
- Apr 19, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 21883 | NY | Primary |
Addresses
Primary practice location
1662 Ocean Ave
Brooklyn, NY 11230-4905
Mailing address
510 Brighton Beach Ave
Apt.208
Brooklyn, NY 11235-6404
Phone (917) 916-1322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21883 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240099200000",
"number": "1750524823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "510 BRIGHTON BEACH AVE",
"address_2": "APT.208",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112356404",
"telephone_number": "917-916-1322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1662 OCEAN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112304905",
"telephone_number": "718-677-4140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXANDER",
"first_name": "EDWARD",
"credential": "SI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-04-19",
"last_updated": "2009-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "21883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.