Provider Demographics
NPI:1477668473
Name:MACLEAN, ALEXANDRA ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:ANNE
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5645 MAIN ST
Mailing Address - Street 2:RM M204
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5045
Mailing Address - Country:US
Mailing Address - Phone:718-445-0220
Mailing Address - Fax:718-939-1167
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:RM M204
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-445-0220
Practice Address - Fax:718-939-1167
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY002654208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery