Provider Demographics
NPI:1114021656
Name:ALDEN J PEARL MD PC
Entity Type:Organization
Organization Name:ALDEN J PEARL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALDEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEARL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-622-0505
Mailing Address - Street 1:34 PLAZA ST E
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-5038
Mailing Address - Country:US
Mailing Address - Phone:718-622-0505
Mailing Address - Fax:718-622-0123
Practice Address - Street 1:34 PLAZA ST E
Practice Address - Street 2:SUITE 106
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5038
Practice Address - Country:US
Practice Address - Phone:718-622-0505
Practice Address - Fax:718-622-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215805207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G47885Medicare UPIN