MEDICARE: ALEX ANTONIO ESTRADA PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NY

General Provider Information

NPI Number	:	1245180272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX ANTONIO ESTRADA PA

Provider Business Mailing Address
First Line	:	39 BIRCHWOOD DR N
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-1905
Country	:	US
Telephone Number	:	516-316-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 OHIO DR STE 200
Second Line	:
City	:	NEW HYDE PARK
State	:	NY
Zip	:	11042-1144
Country	:	US
Telephone Number	:	516-207-7200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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Directions to “ ALEX ANTONIO ESTRADA PA” Practice Location

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