Provider Demographics
NPI:1225838428
Name:BACKSTROM, ALEXANDREA PATRICIA (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:PATRICIA
Last Name:BACKSTROM
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 SOMERTON AVE
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1625
Mailing Address - Country:US
Mailing Address - Phone:716-844-1465
Mailing Address - Fax:
Practice Address - Street 1:73 SOMERTON AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-1625
Practice Address - Country:US
Practice Address - Phone:716-844-1465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY976791163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse