Individual
ALEXA RENEE HAEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
500 PORTION RD STE 11, LAKE RONKONKOMA, NY 11779-4587
(631) 484-0101
Mailing address
500 PORTION RD STE 11, RONKONKOMA, NY 11779-4587
(631) 648-0101
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
024379
NY
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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