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NPI Code Detail

MEDICARE: ALEXANDRA L DWYER

MEDICARE: ALEXANDRA L DWYER
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
1164W00000XLicensed Practical Nurse333578-1NY

General Provider Information

NPI Number : 1801364435
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA L DWYER
Provider Business Mailing Address
First Line : 8 EDWIN LN
Second Line :
City : HUNTINGTON
State : NY
Zip : 11743-2333
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4238 MERRICK RD
Second Line :
City : MASSAPEQUA
State : NY
Zip : 11758-6016
Country : US
Telephone Number : 516-900-1977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2018
Last Update Date : 11/13/2018

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Directions to “ ALEXANDRA L DWYER ” Practice Location

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