Healthcare Provider Details

I. General information

NPI: 1003671587
Provider Name (Legal Business Name): ALEX CARRER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 AVENUE Y
BROOKLYN NY
11235-5010
US

IV. Provider business mailing address

1118 AVENUE Y
BROOKLYN NY
11235-5010
US

V. Phone/Fax

Practice location:
  • Phone: 917-562-4204
  • Fax:
Mailing address:
  • Phone: 917-562-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDRA CAEERE
Title or Position: CEO
Credential: MD
Phone: 917-562-4204