1316984933 NPI number — DR. DANIEL ALEXANDER MD

Table of content: DR. DANIEL ALEXANDER MD (NPI 1316984933)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316984933 NPI number — DR. DANIEL ALEXANDER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDER
Provider First Name:
DANIEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316984933
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
875 PRE EMPTION RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GENEVA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14456-2042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
875 PRE EMPTION RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GENEVA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14456-2042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-789-5061
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207XX0005X , with the licence number:  2322051 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P040232205 . This is a "ROCHESTER BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 145757CU . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2322055W . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02575895 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100245891101 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0598531 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: P010232205 . This is a "BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00399164 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".