Provider Demographics
NPI:1992322739
Name:GEORGES, ALEXIA LAMBOS (CCP)
Entity type:Individual
Prefix:MS
First Name:ALEXIA
Middle Name:LAMBOS
Last Name:GEORGES
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:MS
Other - First Name:ALEXIA
Other - Middle Name:
Other - Last Name:LAMBOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCP
Mailing Address - Street 1:14002 NEW BEDFORD CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3453
Mailing Address - Country:US
Mailing Address - Phone:314-766-5766
Mailing Address - Fax:
Practice Address - Street 1:915 N GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63106-1621
Practice Address - Country:US
Practice Address - Phone:314-652-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-27
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1999136721242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist