Provider Demographics
NPI:1700130986
Name:ALEXANDER, CRYSTAL SUZANNE (RN BSN IBCLC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:SUZANNE
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:RN BSN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 VALLEY FORGE RD
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-2443
Mailing Address - Country:US
Mailing Address - Phone:732-539-4053
Mailing Address - Fax:732-222-0542
Practice Address - Street 1:19 DAVIS AVE FL 7
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4488
Practice Address - Country:US
Practice Address - Phone:732-897-3680
Practice Address - Fax:848-245-8449
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY4246631163WL0100X
NJ26NR09587900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant