Provider Demographics
NPI:1225304496
Name:ETINGER, ALEKSEY (DO)
Entity Type:Individual
Prefix:
First Name:ALEKSEY
Middle Name:
Last Name:ETINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 DOGWOOD AVE # 1091
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQ
Mailing Address - State:NY
Mailing Address - Zip Code:11010-3247
Mailing Address - Country:US
Mailing Address - Phone:516-366-0339
Mailing Address - Fax:844-208-1472
Practice Address - Street 1:259 1ST ST
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3957
Practice Address - Country:US
Practice Address - Phone:516-663-8963
Practice Address - Fax:516-663-8964
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11857000207RC0200X
NY280493207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology