Provider Demographics
NPI:1992295620
Name:WELLS, ALEXANDRIA ELIZABETH (MD, MBS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:ELIZABETH
Last Name:WELLS
Suffix:
Gender:F
Credentials:MD, MBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-444-0650
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-0650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327720207VC0300X, 207VC0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VC0300XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyComplex Family Planning