Provider Demographics
NPI:1972225985
Name:KEYES-MEDRANDA, ALEXANDRA PRECIOUS (MSW)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:PRECIOUS
Last Name:KEYES-MEDRANDA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 LANDER ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4533
Mailing Address - Country:US
Mailing Address - Phone:845-401-7287
Mailing Address - Fax:
Practice Address - Street 1:154 LANDER ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4533
Practice Address - Country:US
Practice Address - Phone:845-401-7287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker