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General NPI Number Information
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NPI Number | 1245233626
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Entity Type | Individual
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Provider Name | ALEXANDRA GERASSIMIDES M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 231 E CHESTNUT ST PATHOLOGY DEPT
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City | LOUISVILLE
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State | KY
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Zip | 40202-1821
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Country | US
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Telephone | 502-456-6212
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Fax | 502-456-4440
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Provider Business Mailing Address
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Address Line | 1941 BISHOP LN STE 1018
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City | LOUISVILLE
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State | KY
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Zip | 40218-1928
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Country | US
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Telephone | 502-456-6211
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Fax | 502-456-4440
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 25558
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207ZP0213X
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Taxonomy Name | Pediatric Pathology Physician
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License Number | 25558
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License Number State | KY
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