Individual
ALEXANDRA CID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 RULAND RD STE 1, MELVILLE, NY 11747-4211
(240) 205-1003
Mailing address
46 BLUEBELL LN, NORTH BABYLON, NY 11703-2803
(240) 205-1003
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
111015
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111015
ASCP
NY
Enumeration date
05/20/2021
Last updated
05/20/2021
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