Provider Demographics
NPI:1184642134
Name:KIRIFIDES, ALEXANDER L (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:L
Last Name:KIRIFIDES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 AAA BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3601
Mailing Address - Country:US
Mailing Address - Phone:302-224-9400
Mailing Address - Fax:302-224-9409
Practice Address - Street 1:875 AAA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3601
Practice Address - Country:US
Practice Address - Phone:302-224-9400
Practice Address - Fax:302-224-9409
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0007603207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000037596Medicaid
DE017877B10Medicare ID - Type Unspecified
DEI41116Medicare UPIN