Provider Demographics
NPI:1952633687
Name:CUFFIE, ALEXANDRA MARILYN (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ALEXANDRA
Middle Name:MARILYN
Last Name:CUFFIE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MISS
Other - First Name:ALEXANDRA
Other - Middle Name:MARILYN
Other - Last Name:CUFFIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:1634 SAINT MARKS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1634 SAINT MARKS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-3388
Practice Address - Country:US
Practice Address - Phone:347-932-1641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY280933-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY280933-1Medicaid