Provider Demographics
NPI:1235310517
Name:MAGALIE ALFRED, MD PEDIATRIC OFFICE PC
Entity Type:Organization
Organization Name:MAGALIE ALFRED, MD PEDIATRIC OFFICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MAGALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALFRED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-465-0593
Mailing Address - Street 1:19602 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2125
Mailing Address - Country:US
Mailing Address - Phone:718-465-0593
Mailing Address - Fax:718-479-7012
Practice Address - Street 1:19602 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2125
Practice Address - Country:US
Practice Address - Phone:718-465-0593
Practice Address - Fax:718-479-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192150208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty