Basic Information
| Provider Information | |||||||||
| NPI: | 1518910694 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALEXANDER | ||||||||
| FirstName: | ALBERT | ||||||||
| MiddleName: | I. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | IV | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10417 | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010412017 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135400150 | ||||||||
| FaxNumber: | 4135400159 | ||||||||
| Practice Location | |||||||||
| Address1: | 2 MEDICAL CENTER DR | ||||||||
| Address2: | SUITE # 404 | ||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011071270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137363163 | ||||||||
| FaxNumber: | 4137330206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 03/14/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 59329 | MA | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 029819 | CT | N | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 3046036 | 05 | MA | MEDICAID | 484240 | 01 | CCARE | OTHER | 1704892 | 01 | UNITED HEALTH CARE | OTHER | 801579 | 01 | HAVARD PILGRAM HEALTH CAR | OTHER | J08141 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 9186280-003 | 01 | CIGNA | OTHER | 10118 | 01 | HEALTH NEW ENGLAND | OTHER | 717899 | 01 | TUFTS | OTHER | 92924 | 01 | AETNA | OTHER |