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General NPI Number Information
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NPI Number | 1104288232
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Entity Type | Individual
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Provider Name | ALEXANDRA J D'AGOSTINI MD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2016
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Last Update Date | 09/23/2022
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Provider Practice Location Address
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Address Line | 218 RIDGEDALE AVE STE 101
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-2109
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Country | US
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Telephone | 973-538-7700
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Fax | 973-538-9478
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Provider Business Mailing Address
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Address Line | 402 LIPPINCOTT DR
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City | MARLTON
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State | NJ
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Zip | 08053-4112
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Country | US
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Telephone | 856-782-3300
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Fax | 856-504-8029
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 89282
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 25MA11623200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 25MA11623200
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License Number State | NJ
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