Provider Demographics
NPI:1093795262
Name:MOGILNER, ALON Y (MD)
Entity Type:Individual
Prefix:DR
First Name:ALON
Middle Name:Y
Last Name:MOGILNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:550 1ST AVE
Mailing Address - Street 2:HCC 3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-2607
Mailing Address - Fax:212-263-4061
Practice Address - Street 1:488 GREAT NECK RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4315
Practice Address - Country:US
Practice Address - Phone:212-263-2607
Practice Address - Fax:212-263-4061
Is Sole Proprietor?:No
Enumeration Date:2006-01-22
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY201834207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02163284Medicaid
NYH41909Medicare UPIN
NY02163284Medicaid