Provider Demographics
NPI:1184866063
Name:ALT, JENNIFER NARCISO (MD)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:NARCISO
Last Name:ALT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 ROUTE 59
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-4927
Mailing Address - Country:US
Mailing Address - Phone:845-357-5775
Mailing Address - Fax:845-357-5777
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-368-5039
Practice Address - Fax:845-368-5327
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2013-05-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY261247207L00000X
NJ25MA09250800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology