Provider Demographics
NPI:1689728321
Name:KREPS, S. ALEXANNDRA (MD)
Entity Type:Individual
Prefix:
First Name:S.
Middle Name:ALEXANNDRA
Last Name:KREPS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 N CRAIG ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2744
Mailing Address - Country:US
Mailing Address - Phone:412-681-3733
Mailing Address - Fax:412-681-4079
Practice Address - Street 1:128 N CRAIG ST
Practice Address - Street 2:SUITE 217
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2744
Practice Address - Country:US
Practice Address - Phone:412-681-3733
Practice Address - Fax:412-681-4079
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030335E2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA07042399Medicaid
PA143680Medicare UPIN
PAE63840Medicare ID - Type Unspecified