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General NPI Number Information
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NPI Number | 1437305380
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Entity Type | Organization
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Legal Business Name | MACRENE ALEXIADES MD PLLC
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 955 PARK AVENUE
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 212-570-2067
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Fax | 212-734-5762
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Provider Business Mailing Address
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Address Line | 955 PARK AVENUE
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City | NEW YORK
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State | NY
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Zip | 10028
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Country | US
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Telephone | 212-570-2067
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. MACRENE RENEE ALEXIADES
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Credential | MD PHD
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Telephone | 917-263-0961
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 212414
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License Number State | NY
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