Provider Demographics
NPI:1588956247
Name:ALMANZAR MOREL, ALEXANDRA (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:ALMANZAR MOREL
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 1:300 TWO MILE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14150-6618
Mailing Address - Country:US
Mailing Address - Phone:716-447-6450
Mailing Address - Fax:
Practice Address - Street 1:101 CEDAR ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1101
Practice Address - Country:US
Practice Address - Phone:508-634-3100
Practice Address - Fax:508-453-8233
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258402208000000X
NY291191208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty