Individual
ALEXANDRA DEMETRIOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L CHT
Contact information
Practice address
1555 SUNRISE HWY, SUITE 2, BAY SHORE, NY 11706-6027
(631) 206-3130
(631) 206-3148
Mailing address
1555 SUNRISE HWY, SUITE 2, BAY SHORE, NY 11706-6027
(631) 206-3130
(631) 206-3148
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
007141-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200424663
TAX PAYER ID
NY
Enumeration date
11/14/2005
Last updated
06/24/2009
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