Provider Demographics
NPI:1477137230
Name:HAIMOWITZ, ALEXANDRA BROOKE (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:BROOKE
Last Name:HAIMOWITZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:321 GREAT KILLS RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-3514
Mailing Address - Country:US
Mailing Address - Phone:347-838-1981
Mailing Address - Fax:
Practice Address - Street 1:1 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-4495
Practice Address - Country:US
Practice Address - Phone:718-390-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant