Provider Demographics
NPI:1720789522
Name:GOLDMANN, ALEXANDRA (NP, STUDENT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:GOLDMANN
Suffix:
Gender:F
Credentials:NP, STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 DEVONSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4524
Mailing Address - Country:US
Mailing Address - Phone:917-562-4896
Mailing Address - Fax:
Practice Address - Street 1:2000 MARCUS AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1069
Practice Address - Country:US
Practice Address - Phone:516-321-6300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program