Provider Demographics
NPI:1396817144
Name:HATSIS, ALEXANDER P (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:P
Last Name:HATSIS
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 1:2 LINCOLN AVE
Mailing Address - Street 2:STE 401
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5775
Mailing Address - Country:US
Mailing Address - Phone:516-763-4106
Mailing Address - Fax:516-763-5216
Practice Address - Street 1:2 LINCOLN AVE
Practice Address - Street 2:STE 401
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5775
Practice Address - Country:US
Practice Address - Phone:516-763-4106
Practice Address - Fax:516-763-5216
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY140263207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY26844POtherHIP
NYAS705OtherOXFORD
NY0076762Medicaid
NY60796OtherAETNA
HA791157OtherGHI
NY6539428OtherCIGNA
NY6539428OtherCIGNA
91A961Medicare ID - Type Unspecified