Provider Demographics
NPI:1154323012
Name:ALESSI, BRIAN C (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:C
Last Name:ALESSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 TURIN RD
Mailing Address - Street 2:BEECHES PROFESSIONAL CAMPUS
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-1900
Mailing Address - Country:US
Mailing Address - Phone:315-336-3380
Mailing Address - Fax:
Practice Address - Street 1:7900 TURIN RD
Practice Address - Street 2:BEECHES PROFESSIONAL CAMPUS
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-1900
Practice Address - Country:US
Practice Address - Phone:315-336-3380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY175847-1207R00000X
NY175847-1207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01180592Medicaid
NYE44057Medicare UPIN
NY01180592Medicaid