Provider Demographics
NPI:1093089856
Name:BRECHER, ALEXANDRA R (MD, PHD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:R
Last Name:BRECHER
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CARLEON AVE
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-3200
Mailing Address - Country:US
Mailing Address - Phone:917-297-7767
Mailing Address - Fax:
Practice Address - Street 1:100 CARLEON AVE
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3200
Practice Address - Country:US
Practice Address - Phone:917-297-7767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219340207NI0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology