Provider Demographics
NPI:1275775413
Name:ALEXANDER, VINCERT (LPN)
Entity Type:Individual
Prefix:
First Name:VINCERT
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 GLENORA DRIVE
Mailing Address - Street 2:APT. 1
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1740
Mailing Address - Country:US
Mailing Address - Phone:585-202-6427
Mailing Address - Fax:
Practice Address - Street 1:158 GLENORA DRIVE
Practice Address - Street 2:APT. 1
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1740
Practice Address - Country:US
Practice Address - Phone:585-202-6427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294970-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse