Basic Information
| Provider Information | |||||||||
| NPI: | 1316984933 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17 LANSING ST | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130211983 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152557576 | ||||||||
| FaxNumber: | 3157028393 | ||||||||
| Practice Location | |||||||||
| Address1: | 77 NELSON ST | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | AUBURN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 130211941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3152527559 | ||||||||
| FaxNumber: | 3152538104 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 11/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 2322051 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 02575895 | 05 | NY | MEDICAID | 100245891101 | 01 | UNITED HEALTHCARE | OTHER | P00399164 | 01 | RAILROAD MEDICARE | OTHER | 0598531 | 01 | GHI | OTHER | 2322055W | 01 | NY | WORKERS COMPENSATION | OTHER | 145757CU | 01 | PREFERRED CARE | OTHER | P010232205 | 01 | BLUE CHOICE | OTHER | P040232205 | 01 | ROCHESTER BLUE SHIELD | OTHER |