Healthcare Provider Details

I. General information

NPI: 1023959269
Provider Name (Legal Business Name): ALEXANDRA DERUGGIERO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

3850 BOSTON ST APT 3001
BALTIMORE MD
21224-5765
US

V. Phone/Fax

Practice location:
  • Phone: 443-798-8773
  • Fax:
Mailing address:
  • Phone: 443-798-8773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberR233681
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN500004952
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: