Provider Demographics
NPI:1366313264
Name:MEDINA, ALEXANDRIA (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:
Last Name:MEDINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ALI
Other - Middle Name:
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:640 PELHAM RD APT 3B
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-1007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52 ROUTE 17K STE 203
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3920
Practice Address - Country:US
Practice Address - Phone:845-565-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX013707-01111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor