Healthcare Provider Details

I. General information

NPI: 1033108899
Provider Name (Legal Business Name): ALEXANDRA I KUFTINEC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 11/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 PLEASANT ST
CONCORD NH
03301-7539
US

IV. Provider business mailing address

250 PLEASANT STREET
CONCORD NH
03301
US

V. Phone/Fax

Practice location:
  • Phone: 603-227-7000
  • Fax:
Mailing address:
  • Phone: 603-227-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number8970
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: