Provider Demographics
NPI:1831949742
Name:NERANTZINIS, ALEXANDRA MARIA (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIA
Last Name:NERANTZINIS
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:GME OFFICE STONY BROOK MEDICINE HSC LEVEL 4, ROOM 176
Mailing Address - Street 2:101 NICOLLS ROAD
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8480
Mailing Address - Country:US
Mailing Address - Phone:631-638-8517
Mailing Address - Fax:631-638-2698
Practice Address - Street 1:GME OFFICE STONY BROOK MEDICINE HSC LEVEL 4, ROOM 176
Practice Address - Street 2:101 NICOLLS ROAD
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-8480
Practice Address - Country:US
Practice Address - Phone:631-638-8517
Practice Address - Fax:631-638-2698
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program