Provider Demographics
NPI:1811154891
Name:BRAUNSTEIN, ALEXANDRA LARA (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:LARA
Last Name:BRAUNSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 W 165TH STREET
Mailing Address - Street 2:HARKNESS EYE INSTITUTE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032
Mailing Address - Country:US
Mailing Address - Phone:212-305-6709
Mailing Address - Fax:212-305-5523
Practice Address - Street 1:635 W 165TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3724
Practice Address - Country:US
Practice Address - Phone:212-305-9535
Practice Address - Fax:212-305-5523
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251240207W00000X
OH35.096988207W00000X
KY44392207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201023550Medicaid
OH3146116Medicaid
KY7100160610Medicaid
OH000000706754OtherBCBS/ANTHEM
OH4319771Medicare PIN
KY002970Medicare PIN