Provider Demographics
NPI:1962573121
Name:ALEKSANDROVICH, VIKTORIYA (MD)
Entity type:Individual
Prefix:
First Name:VIKTORIYA
Middle Name:
Last Name:ALEKSANDROVICH
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 1:501 SURF AVE
Mailing Address - Street 2:APT 9F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3550
Mailing Address - Country:US
Mailing Address - Phone:718-373-2010
Mailing Address - Fax:718-645-7288
Practice Address - Street 1:3080 W 1ST ST
Practice Address - Street 2:SUITE 102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3703
Practice Address - Country:US
Practice Address - Phone:718-207-7071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230654207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02512554Medicaid
NY02512554Medicaid
NYI02932Medicare UPIN