Provider Demographics
NPI:1083872329
Name:MCPENCOW, ALEXANDRA MUHLHAUSER (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MUHLHAUSER
Last Name:MCPENCOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 CEDAR ST
Mailing Address - Street 2:FMB 329A
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3218
Mailing Address - Country:US
Mailing Address - Phone:203-785-6927
Mailing Address - Fax:203-785-2909
Practice Address - Street 1:1450 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4405
Practice Address - Country:US
Practice Address - Phone:203-789-3151
Practice Address - Fax:203-789-3786
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105650207V00000X
CT49454207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology