Provider Demographics
NPI:1780359372
Name:SALCEDO, ALEXANDER (PA)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:SALCEDO
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1973 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-1931
Mailing Address - Country:US
Mailing Address - Phone:631-332-2456
Mailing Address - Fax:
Practice Address - Street 1:NYU LANGONE HOSPITAL LONG ISLAND
Practice Address - Street 2:259 FIRST STREET
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-663-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant