Provider Demographics
NPI:1215631700
Name:PANTOJA, ALEXANDER WILLIAM I
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:WILLIAM
Last Name:PANTOJA
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1388 E LONG ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43203-1975
Mailing Address - Country:US
Mailing Address - Phone:614-779-9797
Mailing Address - Fax:
Practice Address - Street 1:1388 E LONG ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1975
Practice Address - Country:US
Practice Address - Phone:614-779-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health