Provider Demographics
NPI:1164469797
Name:ALPER, MICHAEL MYRON (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MYRON
Last Name:ALPER
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 1:130 2ND AVE
Mailing Address - Street 2:BOSTON IVF - THE WALTHAM CENTER
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-1100
Mailing Address - Country:US
Mailing Address - Phone:781-434-6500
Mailing Address - Fax:781-434-6501
Practice Address - Street 1:725 IRVING AVE STE 600
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1688
Practice Address - Country:US
Practice Address - Phone:518-815-2241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY273323207VE0102X
ME015616207VE0102X, 207VG0400X
MA44412207VG0400X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAD83075Medicare UPIN
MAJ03435Medicare ID - Type Unspecified