Provider Demographics
NPI:1568855591
Name:ALEXANDER, NAIMA (PA-C)
Entity type:Individual
Prefix:MS
First Name:NAIMA
Middle Name:
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:NAIMA
Other - Middle Name:
Other - Last Name:BEGUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 2000
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4500
Mailing Address - Country:US
Mailing Address - Phone:315-362-5129
Mailing Address - Fax:
Practice Address - Street 1:4100 DUFF PL STE A
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1324
Practice Address - Country:US
Practice Address - Phone:516-520-8080
Practice Address - Fax:516-520-8877
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018549363A00000X
261QP3300X, 261QP2300X, 261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic