Provider Demographics
NPI:1508638396
Name:GUARNIERI, ALEXANDRA LEE
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:LEE
Last Name:GUARNIERI
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:LEE
Other - Last Name:SEKULO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 BRYSON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-1922
Mailing Address - Country:US
Mailing Address - Phone:646-431-8206
Mailing Address - Fax:
Practice Address - Street 1:271 BRYSON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-1922
Practice Address - Country:US
Practice Address - Phone:646-431-8206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1244928174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist