Provider Demographics
NPI:1508085523
Name:MADERAZO, ALEX BAER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:BAER
Last Name:MADERAZO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-493-2500
Mailing Address - Fax:914-493-2452
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-2500
Practice Address - Fax:914-493-2452
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2009-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2296512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology