Basic Information
| Provider Information | |||||||||
| NPI: | 1659677680 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALEXANDER KIRSCHENABUM M.D.P.C | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 229 E 79TH ST # 1A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100750866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6464220926 | ||||||||
| FaxNumber: | 2127179503 | ||||||||
| Practice Location | |||||||||
| Address1: | 229 E 79TH ST # 1A | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100750866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6464220926 | ||||||||
| FaxNumber: | 2127179503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/09/2011 | ||||||||
| LastUpdateDate: | 03/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | KIRSCHENABUM | ||||||||
| AuthorizedOfficialFirstName: | ALEXANDER | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 6464220926 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. P.C | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 153872-1 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
No ID Information.