Healthcare Provider Details

I. General information

NPI: 1568995124
Provider Name (Legal Business Name): ALEXANDRA TAFFANY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 MCCLELLAN ST
SCHENECTADY NY
12304-1019
US

IV. Provider business mailing address

711 TROY SCHENECTADY RD STE 203
LATHAM NY
12110-2461
US

V. Phone/Fax

Practice location:
  • Phone: 518-372-5637
  • Fax:
Mailing address:
  • Phone: 518-782-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number296246
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: