Provider Demographics
NPI:1538778337
Name:ANG, ALEXANDRIA LEE DECENA (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA LEE
Middle Name:DECENA
Last Name:ANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 DRIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-2018
Mailing Address - Country:US
Mailing Address - Phone:212-315-8233
Mailing Address - Fax:212-315-8234
Practice Address - Street 1:510 DRIGGS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2018
Practice Address - Country:US
Practice Address - Phone:212-315-8233
Practice Address - Fax:212-315-8234
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
NJ25MA12082500207Q00000X
NY327045207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program