Provider Demographics
NPI:1417501883
Name:ACHENZA, ALEXANDER (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:ACHENZA
Suffix:
Gender:M
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14608 WOONSOCKETT DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5771
Mailing Address - Country:US
Mailing Address - Phone:215-694-9499
Mailing Address - Fax:
Practice Address - Street 1:837 OLNEY SANDY SPRING RD UNIT 10
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1065
Practice Address - Country:US
Practice Address - Phone:410-490-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02627171100000X
FLMA81355225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Yes171100000XOther Service ProvidersAcupuncturist