Provider Demographics
NPI:1912168352
Name:ALEXANDROU, ELEFTHERIOS JOHN (MD)
Entity Type:Individual
Prefix:
First Name:ELEFTHERIOS
Middle Name:JOHN
Last Name:ALEXANDROU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:J
Other - Last Name:ALEXANDROU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:166 CASS AVE UNIT 1
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-4712
Mailing Address - Country:US
Mailing Address - Phone:401-769-2511
Mailing Address - Fax:401-769-7696
Practice Address - Street 1:166 CASS AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4712
Practice Address - Country:US
Practice Address - Phone:401-769-2511
Practice Address - Fax:401-769-7696
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.121093207W00000X
RIMD13402207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI001785101Medicare PIN
IL214235Medicare UPIN