Provider Demographics
NPI:1174393995
Name:TARYGUINA, ALEXANDRA (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:TARYGUINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 LEONARD DR
Mailing Address - Street 2:
Mailing Address - City:EAST NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11731-1447
Mailing Address - Country:US
Mailing Address - Phone:646-409-2501
Mailing Address - Fax:
Practice Address - Street 1:11 LEONARD DR
Practice Address - Street 2:
Practice Address - City:EAST NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11731-1447
Practice Address - Country:US
Practice Address - Phone:646-409-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY767701163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse