Provider Demographics
NPI:1902170129
Name:NAVARRO-GONZALEZ, ALEXANDRA (LPN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:NAVARRO-GONZALEZ
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 SEAMAN AVE
Mailing Address - Street 2:APT. 1-C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-1914
Mailing Address - Country:US
Mailing Address - Phone:917-841-2750
Mailing Address - Fax:
Practice Address - Street 1:60 KNOLLS CRES
Practice Address - Street 2:APT. 2L
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-6319
Practice Address - Country:US
Practice Address - Phone:347-202-7923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305928-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse