Healthcare Provider Details

I. General information

NPI: 1538496807
Provider Name (Legal Business Name): VANAJA NANDINI ALEXANDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2009
Last Update Date: 08/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 5TH ST S
ARLINGTON VA
22204-1681
US

IV. Provider business mailing address

25 ADAMS AVE UNIT 215
STAMFORD CT
06902-3786
US

V. Phone/Fax

Practice location:
  • Phone: 703-403-4672
  • Fax:
Mailing address:
  • Phone: 203-832-0360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number243433
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: