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NPI Code Detail

MEDICARE: ALEXANDRA AJIBADE AGPCNP-BC

MEDICARE: ALEXANDRA AJIBADE AGPCNP-BC
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
1363LG0600XGerontology Nurse Practitioner2022138430NY
2163W00000XRegistered Nurse641239NY
3363LG0600XGerontology Nurse Practitioner311233NY

General Provider Information

NPI Number : 1982982765
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA AJIBADE AGPCNP-BC
Provider Business Mailing Address
First Line : 22 AVENUE B
Second Line :
City : HELMETTA
State : NJ
Zip : 08828-1239
Country : US
Telephone Number : 347-733-9488
Fax Number :
Provider Business Practice Location Address
First Line : 2601 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11235-7745
Country : US
Telephone Number : 718-616-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2011
Last Update Date : 05/13/2026

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