Provider Demographics
NPI:1497751523
Name:DECHIARIO, ALAN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ANTHONY
Last Name:DECHIARIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:635 MADISON AVE
Mailing Address - Street 2:FL 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-1009
Mailing Address - Country:US
Mailing Address - Phone:212-857-4511
Mailing Address - Fax:212-752-3390
Practice Address - Street 1:635 MADISON AVE
Practice Address - Street 2:FL 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-1009
Practice Address - Country:US
Practice Address - Phone:212-857-4511
Practice Address - Fax:212-752-3390
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY190796207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF72546Medicare UPIN
NYAD032I0910Medicare ID - Type Unspecified