Provider Demographics
NPI:1508035981
Name:BEROTTI, ALAN JOSEPH
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:JOSEPH
Last Name:BEROTTI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NOSTRAND ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4307
Mailing Address - Country:US
Mailing Address - Phone:516-816-6837
Mailing Address - Fax:631-694-0131
Practice Address - Street 1:10 NOSTRAND ST
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4307
Practice Address - Country:US
Practice Address - Phone:516-816-6837
Practice Address - Fax:631-694-0131
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor