Provider Demographics
NPI:1336735430
Name:ALEXANDER HESQUIJAROSA MD
Entity type:Organization
Organization Name:ALEXANDER HESQUIJAROSA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:HESQUIJAROSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:551-223-5950
Mailing Address - Street 1:400 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NJ
Mailing Address - Zip Code:07022-1917
Mailing Address - Country:US
Mailing Address - Phone:551-223-5950
Mailing Address - Fax:
Practice Address - Street 1:400 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NJ
Practice Address - Zip Code:07022-1917
Practice Address - Country:US
Practice Address - Phone:551-223-5950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty