Provider Demographics
NPI:1528010386
Name:DOSIK, ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:DOSIK
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 1:500 4TH AVENUE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4881
Mailing Address - Country:US
Mailing Address - Phone:718-208-1820
Mailing Address - Fax:718-208-1822
Practice Address - Street 1:500 4TH AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-4881
Practice Address - Country:US
Practice Address - Phone:718-208-1820
Practice Address - Fax:718-208-1822
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210889207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02379326Medicaid
NY141AM1Medicare PIN
H90499Medicare UPIN