Provider Demographics
NPI:1376796318
Name:ALEXANDRO, CARLOS SR (MS,OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:ALEXANDRO
Suffix:SR
Gender:M
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 SYCORA LN
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1617
Mailing Address - Country:US
Mailing Address - Phone:646-251-9934
Mailing Address - Fax:631-232-2686
Practice Address - Street 1:27 SYCORA LN
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1617
Practice Address - Country:US
Practice Address - Phone:646-251-9934
Practice Address - Fax:631-232-2686
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011364-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist