Provider Demographics
NPI:1316909195
Name:ZAGORIN, ALEKSANDRA (NP)
Entity type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:ZAGORIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4802 10TH AVE
Mailing Address - Street 2:MAIMONIDES MEDICAL CENTER GERIATRICS DIVISION
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-2844
Mailing Address - Country:US
Mailing Address - Phone:718-283-7071
Mailing Address - Fax:
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:MAIMONIDES MEDICAL CENTER GERIATRIC DIVISION
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:718-283-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340559-1363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP3165982OtherOXFORD PROVIDER ID
NY02421992Medicaid
NY0375G1Medicare ID - Type Unspecified
NY02421992Medicaid