Provider Demographics
NPI:1326097403
Name:ROVNER, ALEXANDER V (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:V
Last Name:ROVNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1801 GRAND ISLAND BLVD
Mailing Address - Street 2:C
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-2171
Mailing Address - Country:US
Mailing Address - Phone:716-404-2604
Mailing Address - Fax:716-404-2692
Practice Address - Street 1:1801 GRAND ISLAND BLVD
Practice Address - Street 2:# C
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-2171
Practice Address - Country:US
Practice Address - Phone:716-913-3917
Practice Address - Fax:716-404-2692
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2024-03-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PATMD0051902084N0402X
PAMD4738162084N0402X
NY238610-12084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02798570Medicaid
NYRB3230Medicare PIN
NYI73735Medicare UPIN