Provider Demographics
NPI:1598049884
Name:ANGEL ALCANTARA, M.D., P.C.
Entity Type:Organization
Organization Name:ANGEL ALCANTARA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALCANTARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-917-3639
Mailing Address - Street 1:2360 AMSTERDAM AVE
Mailing Address - Street 2:SUITE M-2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-7362
Mailing Address - Country:US
Mailing Address - Phone:646-678-5222
Mailing Address - Fax:646-678-5119
Practice Address - Street 1:2360 AMSTERDAM AVE
Practice Address - Street 2:SUITE M-2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7362
Practice Address - Country:US
Practice Address - Phone:646-678-5222
Practice Address - Fax:646-678-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-05
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2145352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02086322Medicaid
NYH18456Medicare UPIN
NY02086322Medicaid