Healthcare Provider Details

I. General information

NPI: 1316909195
Provider Name (Legal Business Name): ALEKSANDRA ZAGORIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4802 10TH AVE MAIMONIDES MEDICAL CENTER GERIATRIC DIVISION
BROOKLYN NY
11219-2916
US

IV. Provider business mailing address

4802 10TH AVE MAIMONIDES MEDICAL CENTER GERIATRICS DIVISION
BROOKLYN NY
11219-2844
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-7071
  • Fax:
Mailing address:
  • Phone: 718-283-7071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberF340559-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: