Provider Demographics
NPI:1437235926
Name:COFFINO, ALAN R (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:R
Last Name:COFFINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:53 PEEKSKILL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579
Mailing Address - Country:US
Mailing Address - Phone:845-528-5700
Mailing Address - Fax:845-528-0134
Practice Address - Street 1:53 PEEKSKILL HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579
Practice Address - Country:US
Practice Address - Phone:845-528-5700
Practice Address - Fax:845-528-0134
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2134591207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY60C771Medicare ID - Type Unspecified
H106072Medicare UPIN