Basic Information
| Provider Information | |||||||||
| NPI: | 1215096243 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 820933 | ||||||||
| Address2: | |||||||||
| City: | PHILA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159269022 | ||||||||
| FaxNumber: | 2152268286 | ||||||||
| Practice Location | |||||||||
| Address1: | 4168 GERMANTOWN AVENUE | ||||||||
| Address2: | |||||||||
| City: | PHILA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191402946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153240500 | ||||||||
| FaxNumber: | 2153243767 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2006 | ||||||||
| LastUpdateDate: | 07/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD056081L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1855795 | 01 | PA | CIGNA PIN | OTHER | 2836592000 | 01 | PA | IBC/KHPE/PC | OTHER | 5552322 | 01 | PA | AETNA PIN | OTHER | P00721294 | 01 | PA | RR MEDICARE | OTHER | 597586 | 01 | PA | MEDICARE GROUP | OTHER | 2053189 | 01 | PA | UNITED HEALTHCARE | OTHER | 102117408 | 05 | PA | MEDICAID | 1957179 | 01 | PA | HBS | OTHER | 3Y6260 | 01 | PA | HEALTH NET | OTHER |