Provider Demographics
NPI:1548414287
Name:BRIAN C ALESSI MD PC
Entity Type:Organization
Organization Name:BRIAN C ALESSI MD PC
Other - Org Name:MOHAWK VALLEY PRACTITIONERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:LUKE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:315-733-7913
Mailing Address - Street 1:1 NOTRE DAME LN
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-4817
Mailing Address - Country:US
Mailing Address - Phone:315-733-7913
Mailing Address - Fax:315-624-7796
Practice Address - Street 1:1 NOTRE DAME LN
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13502-4817
Practice Address - Country:US
Practice Address - Phone:315-733-7913
Practice Address - Fax:315-624-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1758471261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center