Individual
ALEXANDRA DEREVNUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
17 E 102ND ST, 2ND FLOOR EHS, NEW YORK, NY 10029-5204
(212) 824-7690
(212) 426-7704
Mailing address
1425 MADISON AVE, L2-92, NEW YORK, NY 10029-6514
(212) 659-9450
(212) 987-4006
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
332437
NY
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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