Provider Demographics
NPI:1497083026
Name:NISCHAL, ALKA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALKA
Middle Name:
Last Name:NISCHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALKA
Other - Middle Name:
Other - Last Name:NISCHAL-REDNAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:222 STATION PLZ N STE 518
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3893
Mailing Address - Country:US
Mailing Address - Phone:516-663-2588
Mailing Address - Fax:
Practice Address - Street 1:222 STATION PLZ N
Practice Address - Street 2:SUITE 518
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3800
Practice Address - Country:US
Practice Address - Phone:516-663-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-19
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253772207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY253772OtherSTATE LICENSE