Provider Demographics
NPI:1407739113
Name:RENE, ALEXANDRA CARLA
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:CARLA
Last Name:RENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1411
Mailing Address - Country:US
Mailing Address - Phone:857-318-3380
Mailing Address - Fax:
Practice Address - Street 1:14 UNION AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-1411
Practice Address - Country:US
Practice Address - Phone:857-318-3380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty