Individual
MS. ALEXA KOVLAKAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2510 30TH AVE, ASTORIA, NY 11102-2418
(718) 932-1000
Mailing address
1721 WOODBINE ST APT 3R, RIDGEWOOD, NY 11385-3600
(203) 455-4398
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
029303
NY
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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