MEDICARE: MRS. ALEXANDRA TRZNADEL

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1255814372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALEXANDRA TRZNADEL

Provider Business Mailing Address
First Line	:	332 LASKIN RD APT 245
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-3067
Country	:	US
Telephone Number	:	508-699-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2008 GENERAL BOOTH BLVD STE B
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-5910
Country	:	US
Telephone Number	:	757-301-2411
Fax Number	:

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

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	01/22/2024

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