Provider Demographics
NPI:1275618951
Name:LEGATT, ALAN D (MD,PHD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:LEGATT
Suffix:
Gender:M
Credentials:MD,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 DELLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-4945
Mailing Address - Country:US
Mailing Address - Phone:914-428-7685
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:DEPT. OF NEUROLOGY, MONTEFIORE MEDICAL CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-6530
Practice Address - Fax:718-920-8509
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1518112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00978661Medicaid
NY00978661Medicaid