Individual
ALEXANDRE GENNADIEVICH ANDRIANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 W MAIN ST STE 350, BABYLON, NY 11702-3025
(631) 517-9170
Mailing address
400 W MAIN ST, STE 350, BABYLON, NY 11702-3025
(516) 297-1753
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
270960
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061454
ANTHEM
—
Enumeration date
10/19/2005
Last updated
12/01/2025
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