Provider Demographics
NPI:1982773545
Name:ALEXANDER, FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 ROUTE 17 NORTH
Mailing Address - Street 2:SUITE 321
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-225-9700
Mailing Address - Fax:201-225-0031
Practice Address - Street 1:140 ROUTE 17 NORTH
Practice Address - Street 2:SUITE 321
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-225-9700
Practice Address - Fax:201-225-0031
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062565A2086S0120X
NJ25MA081959002086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C65079Medicare UPIN