Healthcare Provider Details

I. General information

NPI: 1497297063
Provider Name (Legal Business Name): ALEKSANDRA DONTSOVA AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2016
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W BLACKWELL ST
DOVER NJ
07801-2525
US

IV. Provider business mailing address

69 THE FELLSWAY
NEW PROVIDNCE NJ
07974-2348
US

V. Phone/Fax

Practice location:
  • Phone: 973-989-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00679400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NJ00679400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number26NJ00679400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: