Provider Demographics
NPI:1437710969
Name:ELLWOOD, ALEXANDRA MARIE
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:ELLWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 DENNIS ST
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:PA
Mailing Address - Zip Code:15037-2510
Mailing Address - Country:US
Mailing Address - Phone:412-926-3597
Mailing Address - Fax:
Practice Address - Street 1:575 COAL VALLEY RD STE 277
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3716
Practice Address - Country:US
Practice Address - Phone:412-469-7722
Practice Address - Fax:412-469-7721
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical