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General NPI Number Information
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NPI Number | 1881353340
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Entity Type | Individual
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Provider Name | ALEXANDRA CRIST
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Gender | Female
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Dates
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Enumeration Date | 12/13/2021
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 1425 PORTLAND AVE BLDG 3
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City | ROCHESTER
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State | NY
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Zip | 14621-3095
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Country | US
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Telephone | 585-455-1310
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 HUNTS PARK RD APT 42G
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City | FARMINGTON
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State | NY
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Zip | 14425-9511
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Country | US
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Telephone | 315-576-0965
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 432064
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License Number State | NY
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