Provider Demographics
NPI:1588812929
Name:FITZGERALD ALCINDOR MD PLLC
Entity Type:Organization
Organization Name:FITZGERALD ALCINDOR MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FITZGERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCINDOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-489-9440
Mailing Address - Street 1:22 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-2411
Mailing Address - Country:US
Mailing Address - Phone:516-489-9440
Mailing Address - Fax:516-489-9014
Practice Address - Street 1:22 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-2411
Practice Address - Country:US
Practice Address - Phone:516-489-9440
Practice Address - Fax:516-489-9014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY195447261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care