1336426857 NPI number — LESLIE E ALEXANDER CRNA

Table of content: LESLIE E ALEXANDER CRNA (NPI 1336426857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336426857 NPI number — LESLIE E ALEXANDER CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEXANDER
Provider First Name:
LESLIE
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

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:
1336426857
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 READS WAY
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
NEW CASTLE
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19720-1630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-709-4709
Provider Business Mailing Address Fax Number:
302-709-4551

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4755 OGLETOWN STANTON ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19718-1320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-733-1000
Provider Business Practice Location Address Fax Number:
302-733-2685
Provider Enumeration Date:
11/11/2011

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: 367500000X , with the licence number:  2275948 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: RN2275948 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: L6-0A00721 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X , with the licence number: AC005701 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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