MEDICARE: ALEXANDRA ALBINO DACM, LAC

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	171100000X	Acupuncturist	007182	NY

General Provider Information

NPI Number	:	1811608730
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA ALBINO DACM, LAC

Provider Business Mailing Address
First Line	:	287 LOUDON RD
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12211-2015
Country	:	US
Telephone Number	:	518-248-7361
Fax Number	:

Provider Business Practice Location Address
First Line	:	560 DELAWARE AVE
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12209-1415
Country	:	US
Telephone Number	:	518-227-1669
Fax Number	:

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

Provider Enumeration Date	:	12/12/2022
Last Update Date	:	12/12/2022

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