Individual
ALEXANDRA ANSELMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
167 E MERRICK RD, VALLEY STREAM, NY 11580-5925
(516) 825-3030
Mailing address
4830 40TH ST APT 7K, SUNNYSIDE, NY 11104-4131
(516) 732-1829
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
382868
NY
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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