Provider Demographics
NPI:1437573722
Name:DILUZIO, ALEXANDRA RITTENBERG (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:RITTENBERG
Last Name:DILUZIO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE STE 220
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1168
Mailing Address - Country:US
Mailing Address - Phone:770-429-0083
Mailing Address - Fax:770-425-0137
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 460
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-427-7389
Practice Address - Fax:770-427-1492
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA7105363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7105OtherPA LICENSE