Provider Demographics
NPI:1053176164
Name:STEWART, ALEXANDRIA SHENIKA
Entity type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:SHENIKA
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 METROPOLITAN OVAL APT 1C
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-6503
Mailing Address - Country:US
Mailing Address - Phone:917-513-9585
Mailing Address - Fax:
Practice Address - Street 1:11 METROPOLITAN OVAL APT 1C
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-6503
Practice Address - Country:US
Practice Address - Phone:917-513-9585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY776342163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy