Healthcare Provider Details

I. General information

NPI: 1861867699
Provider Name (Legal Business Name): ALEXANDRA KASSIMIR UNGER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. ALEXANDRA BAUM KASSIMIR

II. Dates (important events)

Enumeration Date: 12/04/2015
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 OAKWOOD RD
HUNTINGTON NY
11743-4229
US

IV. Provider business mailing address

23 OAKWOOD RD
HUNTINGTON NY
11743-4229
US

V. Phone/Fax

Practice location:
  • Phone: 631-629-5507
  • Fax:
Mailing address:
  • Phone: 631-629-5507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number037832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: