Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 279104 | NY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 279104 | NY |
NPI | 1093948812 |
---|---|
Provider Name | Alexander Tejani |
First Address | Staten Island, NY 10309-1207 |
Second Address | Staten Island, NY 10306-3608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2009 |
Last Update Date | 08/01/2019 |