Individual
MR. ALEXANDER PEGUERO-MEDRANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
169 PUTNAM HALL, STONY BROOK, NY 11794-3240
(631) 632-9510
(631) 632-5870
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 632-9510
(631) 632-5870
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402196
NY
Other
Enumeration date
05/26/2017
Last updated
12/27/2022
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