Individual provider · Type 1 NPI
Alexandra Derevnuk, FNP
Adult Health Nurse Practitioner · New York, NY
NPI number
1609155423
Active
Practice location
17 E 102nd St, 2nd Floor Ehs
New York, NY 10029-5204
Fax (212) 426-7704
Mailing address
1425 Madison Ave, L2-92
New York, NY 10029-6514
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | 332437 (NY) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1609155423
Alexandra Derevnuk, FNP's National Provider Identifier is 1609155423, issued on Aug 10, 2011. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in New York, NY. The record was last updated on Aug 10, 2011.