Healthcare Provider Details

I. General information

NPI: 1083872329
Provider Name (Legal Business Name): ALEXANDRA MUHLHAUSER MCPENCOW MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 02/04/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 CHAPEL ST
NEW HAVEN CT
06511-4405
US

IV. Provider business mailing address

310 CEDAR ST FMB 329A
NEW HAVEN CT
06510-3218
US

V. Phone/Fax

Practice location:
  • Phone: 203-789-3151
  • Fax: 203-789-3786
Mailing address:
  • Phone: 203-785-6927
  • Fax: 203-785-2909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA105650
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number49454
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: