Healthcare Provider Details

I. General information

NPI: 1871378182
Provider Name (Legal Business Name): ALONDRA SEVERINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2023
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 WHITE PLAINS RD
BRONX NY
10472-4900
US

IV. Provider business mailing address

1501 UNDERCLIFF AVE APT 6K
BRONX NY
10453-7147
US

V. Phone/Fax

Practice location:
  • Phone: 718-828-6610
  • Fax:
Mailing address:
  • Phone: 347-200-3512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF002239-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: