Provider Demographics
NPI:1285724914
Name:SEMMA MEDICAL PLLC
Entity type:Organization
Organization Name:SEMMA MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISABETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALEXIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-932-7315
Mailing Address - Street 1:2414 33RD ST
Mailing Address - Street 2:STE A
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1137
Mailing Address - Country:US
Mailing Address - Phone:718-932-7315
Mailing Address - Fax:718-956-0254
Practice Address - Street 1:2414 33RD ST
Practice Address - Street 2:STE A
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1137
Practice Address - Country:US
Practice Address - Phone:718-932-7315
Practice Address - Fax:718-956-0254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144701-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000348070301OtherHEALTH PLUS
NY010255102OtherAMERICHOICE
NY01148241Medicaid
NY000152630501OtherHEALTH PLUS
NY06068OtherGHI MEDICARE
NY137667143OtherAETNA
NY181085POtherHIP
NY425AN1OtherEMPIRE BLUE CROSS BLUE SH
NY137667143A01OtherCAREPLUS
NY425AN2OtherEMPIRE BLUE CROSS BLUE SH
NY425AN3OtherEMPIRE BLUE CROSS BLUE SH
NYP3118171OtherOXFORD
NY81F951OtherEMPIRE BLUECROSS BLUE SHE
NY000000087179OtherGHI HMO
NY232908OtherWELLCARE
NY137667143OtherAETNA