Alexandra Desimone
Family Medicine in Marlton, NJ. Individual provider (NPI-1).
NPI number1306228143
StatusActive
Last updated in NPPESMar 17, 2022
Details
- NPI
- 1306228143
- Entity type
- Individual (NPI-1)
- Name
- Alexandra Desimone
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2015
- Certification date
- Mar 17, 2022
- Last updated
- Mar 17, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 25MA10348700 | NJ | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Other names
- Alexandra Mineo (Former Name)
Practice location
141 Route 70 E Ste EMarlton, NJ 08053-1855
Phone 856-985-7373 · Fax 856-985-9611
Mailing address
301 Lippincott Dr Ste 410Marlton, NJ 08053-4197
Phone 856-355-0340 · Fax 856-355-0330
Other practice locations
425 1st St
Brooklyn, NY 11215-2507
Brooklyn, NY 11215-2507
Phone 518-932-9323
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