Provider Demographics
NPI:1932369972
Name:CAIAZZO, ALEXANDRA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:
Last Name:CAIAZZO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 THOMPSON SQUARE MALL
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:NY
Mailing Address - Zip Code:12701-3220
Mailing Address - Country:US
Mailing Address - Phone:845-794-0237
Mailing Address - Fax:845-794-0257
Practice Address - Street 1:46 THOMPSON SQUARE MALL
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:NY
Practice Address - Zip Code:12701-3220
Practice Address - Country:US
Practice Address - Phone:845-794-0237
Practice Address - Fax:845-794-0257
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048058183500000X
FLPS35789183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist