Provider Demographics
NPI:1861867699
Name:UNGER, ALEXANDRA KASSIMIR (DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:KASSIMIR
Last Name:UNGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:BAUM
Other - Last Name:KASSIMIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1470 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6021
Mailing Address - Country:US
Mailing Address - Phone:631-446-1480
Mailing Address - Fax:631-446-1478
Practice Address - Street 1:1470 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6021
Practice Address - Country:US
Practice Address - Phone:631-446-1480
Practice Address - Fax:631-446-1478
Is Sole Proprietor?:No
Enumeration Date:2015-12-04
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037832225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist