Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alexandre Ivanov

Individual provider Nutrition Support Pharmacist · NPI 1851269823

Alexandre Ivanov is a Nutrition Support Pharmacist in Lawrenceville, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2025

Practice location Address checks out

2512 Young America Dr
Lawrenceville, GA 30043-8002
Phone: (909) 224-4220
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nutrition Support Pharmacist (primary) Taxonomy 1835N1003X · Licence RPH029265 (GA)

Record details

NPI number1851269823
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 29, 2025
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025
Mailing address2512 Young America Dr, Lawrenceville, GA 30043-8002