Provider Demographics
NPI:1871378182
Name:SEVERINO, ALONDRA
Entity type:Individual
Prefix:
First Name:ALONDRA
Middle Name:
Last Name:SEVERINO
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 1:1501 UNDERCLIFF AVE APT 6K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-7147
Mailing Address - Country:US
Mailing Address - Phone:347-200-3512
Mailing Address - Fax:
Practice Address - Street 1:1211 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10472-4900
Practice Address - Country:US
Practice Address - Phone:718-828-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF002239-01367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife