Provider Demographics
NPI:1235954629
Name:GARCIA-BETANCOURT, ALEXANDRA MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MICHELLE
Last Name:GARCIA-BETANCOURT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:MICHELLE
Other - Last Name:BETANCOURT-PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1044 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12307-1508
Mailing Address - Country:US
Mailing Address - Phone:518-370-1441
Mailing Address - Fax:518-395-9431
Practice Address - Street 1:67 DIVISION ST STE 2
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4099
Practice Address - Country:US
Practice Address - Phone:518-627-2110
Practice Address - Fax:518-627-2112
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF355911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53099AOtherMEDICARE PIN
NY02995513Medicaid
NY331833OtherMEDICARE OSCAR