Provider Demographics
NPI:1801683560
Name:ROA, NADIWSKA ALEXANDRA (MD)
Entity type:Individual
Prefix:
First Name:NADIWSKA
Middle Name:ALEXANDRA
Last Name:ROA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LUIS CRUZ AP-003515
Mailing Address - Street 2:8540 NW 66TH ST
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33195-2698
Mailing Address - Country:US
Mailing Address - Phone:305-436-1197
Mailing Address - Fax:
Practice Address - Street 1:79-01 BROADWAY , ELMHURST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:11373
Practice Address - Country:US
Practice Address - Phone:718-334-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program