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General NPI Number Information
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NPI Number | 1700686375
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Entity Type | Individual
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Provider Name | MRS. ALEXANDRA MARTE PENALVER
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 763 LARKFIELD RD FL 2
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City | COMMACK
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State | NY
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Zip | 11725-3131
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Country | US
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Telephone | 631-837-2359
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Fax |
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Provider Business Mailing Address
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Address Line | 281 LILAC LN
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City | SMITHTOWN
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State | NY
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Zip | 11787-4412
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Country | US
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Telephone | 201-587-3821
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 356891
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9443931
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 800796
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR19050600
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License Number State | NJ
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