Healthcare Provider Details

I. General information

NPI: 1912068123
Provider Name (Legal Business Name): ALEXANDRA COSTA SCHNEIDER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7161 HIGH ST
LIMA NY
14485-9569
US

IV. Provider business mailing address

7161 HIGH ST
LIMA NY
14485-9569
US

V. Phone/Fax

Practice location:
  • Phone: 585-727-2250
  • Fax:
Mailing address:
  • Phone: 585-727-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number392634-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF332150-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: