Healthcare Provider Details

I. General information

NPI: 1821819871
Provider Name (Legal Business Name): ALEXA CHRISTINA ANDRUZZI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 HYLAN BLVD
STATEN ISLAND NY
10306-4653
US

IV. Provider business mailing address

218 ABINGDON AVE
STATEN ISLAND NY
10308-1336
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-1212
  • Fax: 718-351-4114
Mailing address:
  • Phone: 917-816-1662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number032689
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: