Provider Demographics
NPI:1417188590
Name:ALPERT, EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:ALPERT
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 1:361 PARKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:PARKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12768
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:361 PARKSVILLE RD
Practice Address - Street 2:
Practice Address - City:PARKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12768
Practice Address - Country:US
Practice Address - Phone:845-292-6821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199615207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine