Provider Demographics
NPI:1104288232
Name:D'AGOSTINI, ALEXANDRA J (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:J
Last Name:D'AGOSTINI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:218 RIDGEDALE AVE STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2109
Practice Address - Country:US
Practice Address - Phone:973-538-7700
Practice Address - Fax:973-538-9478
Is Sole Proprietor?:No
Enumeration Date:2016-03-28
Last Update Date:2022-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA89282207X00000X
NJ25MA11623200207X00000X, 207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery