Provider Demographics
NPI:1861546251
Name:WORTMAN, ALEJANDRA (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:WORTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:50 S 16TH ST UNIT 4310
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2533
Mailing Address - Country:US
Mailing Address - Phone:203-869-5505
Mailing Address - Fax:203-869-5504
Practice Address - Street 1:255 S 17TH ST STE 2900
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6201
Practice Address - Country:US
Practice Address - Phone:203-869-5505
Practice Address - Fax:038-695-5042
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2161232084P0804X
CT0398442084P0804X
PA4780632084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry