Provider Demographics
NPI:1659668770
Name:MORIM, ALEKSANDR (MD MBA)
Entity type:Individual
Prefix:DR
First Name:ALEKSANDR
Middle Name:
Last Name:MORIM
Suffix:
Gender:M
Credentials:MD MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 246TH ST
Mailing Address - Street 2:APT 1425
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3631
Mailing Address - Country:US
Mailing Address - Phone:347-610-2856
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-10
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2832512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology