Healthcare Provider Details

I. General information

NPI: 1144768979
Provider Name (Legal Business Name): ALEXANDRA JEAN BAPTISTE MD,PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALEXANDRA SENAT MD, PA

II. Dates (important events)

Enumeration Date: 01/31/2017
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 HANCOCK ST
BOSTON MA
02125-2147
US

IV. Provider business mailing address

42 EASTERN AVE
MALDEN MA
02148-5014
US

V. Phone/Fax

Practice location:
  • Phone: 888-774-6306
  • Fax: 888-731-6233
Mailing address:
  • Phone: 781-605-3438
  • Fax: 781-605-3681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number888
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number888-PA
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: