Provider Demographics
NPI:1588385280
Name:ECONOMOS, ALEXANDRA (PA-C)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ECONOMOS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7600 OSLER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7701
Mailing Address - Country:US
Mailing Address - Phone:410-321-8425
Mailing Address - Fax:410-828-5217
Practice Address - Street 1:7600 OSLER DR STE 200
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7701
Practice Address - Country:US
Practice Address - Phone:410-321-8452
Practice Address - Fax:410-828-5217
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant