Basic Information
Provider Information | |||||||||
NPI: | 1609047067 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GAFFNEY-ADAMS | ||||||||
FirstName: | ALEXEA | ||||||||
MiddleName: | M | ||||||||
NamePrefix: | MISS | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 45 RESEARCH WAY SUITE 204 | ||||||||
Address2: | STONY BROOK ADMINISTRATIVE SERVICES LLC | ||||||||
City: | E. SETAUKET | ||||||||
State: | NY | ||||||||
PostalCode: | 11733 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6316158279 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 205 N. BELLE MEADE RD | ||||||||
Address2: | STONY BROOK INTERNAL MEDICINE | ||||||||
City: | E. SETAUKET | ||||||||
State: | NY | ||||||||
PostalCode: | 11733 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 6314444630 | ||||||||
FaxNumber: | 6314444617 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/13/2008 | ||||||||
LastUpdateDate: | 01/13/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 266926 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.