Provider Demographics
NPI:1700686375
Name:PENALVER, ALEXANDRA MARTE
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:MARTE
Last Name:PENALVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:MARTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:281 LILAC LN
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-4412
Mailing Address - Country:US
Mailing Address - Phone:201-587-3821
Mailing Address - Fax:
Practice Address - Street 1:281 LILAC LN
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-4412
Practice Address - Country:US
Practice Address - Phone:201-587-3821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19050600163W00000X
NY800796163W00000X
FLRN9443931163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse