Provider Demographics
NPI:1821583766
Name:DIAS, ALEXANDRA (DO)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:DIAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 LONG WHARF DR STE 503
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5593
Mailing Address - Country:US
Mailing Address - Phone:203-785-5809
Mailing Address - Fax:203-764-9149
Practice Address - Street 1:1 LONG WHARF DR STE 503
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5593
Practice Address - Country:US
Practice Address - Phone:203-785-5809
Practice Address - Fax:203-764-9149
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-23
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT68046208000000X, 2080P0205X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics