Basic Information
| Provider Information | |||||||||
| NPI: | 1902964414 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | JOSEPH ALESSANDRO | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BROOKLYN FAMILY MEDICINE | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 63 CANTERBURY RD | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 062341901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607795940 | ||||||||
| FaxNumber: | 8607795499 | ||||||||
| Practice Location | |||||||||
| Address1: | 63 CANTERBURY RD | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 062341901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8607795940 | ||||||||
| FaxNumber: | 8607795499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KOSKI | ||||||||
| AuthorizedOfficialFirstName: | BRENDA | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING | ||||||||
| AuthorizedOfficialTelephone: | 8607795940 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 000477 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.