Provider Demographics
NPI:1265460604
Name:SHRAGA, ALEXANDER (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:SHRAGA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:ALEXANDER
Other - Middle Name:
Other - Last Name:SRAGOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:385 ROUTE 18
Mailing Address - Street 2:SUITE C
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-390-1883
Mailing Address - Fax:732-907-1711
Practice Address - Street 1:385 ROUTE 18
Practice Address - Street 2:SUITE C
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-390-1883
Practice Address - Fax:732-907-1711
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07491000207N00000X
NY227114207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2688539000OtherAMERIHEALTH GROUP NUMBER
NJ2255993000OtherAMERIHEALTH INDIVIDUAL NO
NJ1207739OtherAETNA
NJ070441Medicare PIN
NJ1207739OtherAETNA