Healthcare Provider Details

I. General information

NPI: 1336227172
Provider Name (Legal Business Name): ALEXANDRA J. LANSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 GEORGE ST SUITE 759
NEW HAVEN CT
06511-6624
US

IV. Provider business mailing address

300 GEORGE ST SUITE 759
NEW HAVEN CT
06511-6624
US

V. Phone/Fax

Practice location:
  • Phone: 203-737-2142
  • Fax: 203-737-6118
Mailing address:
  • Phone: 203-737-2142
  • Fax: 203-737-6118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number216597
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number216597
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number049263
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: