Provider Demographics
NPI:1811086366
Name:ALEXANDER MEDICAL GROUP PC
Entity type:Organization
Organization Name:ALEXANDER MEDICAL GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-546-1272
Mailing Address - Street 1:222 ALEXANDER ST
Mailing Address - Street 2:STE 2400
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-4004
Mailing Address - Country:US
Mailing Address - Phone:585-546-1272
Mailing Address - Fax:585-325-4443
Practice Address - Street 1:222 ALEXANDER ST
Practice Address - Street 2:SUITE 2400
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-4004
Practice Address - Country:US
Practice Address - Phone:585-546-1272
Practice Address - Fax:585-325-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY34613AMedicare ID - Type Unspecified