Provider Demographics
NPI:1629094511
Name:DASCANIO, ALFREDO (MD)
Entity Type:Individual
Prefix:MR
First Name:ALFREDO
Middle Name:
Last Name:DASCANIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:60 GOLDENS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3447
Mailing Address - Country:US
Mailing Address - Phone:914-232-1919
Mailing Address - Fax:914-232-3255
Practice Address - Street 1:ONE S GREELEY AVE
Practice Address - Street 2:STE 303
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514
Practice Address - Country:US
Practice Address - Phone:914-238-0801
Practice Address - Fax:914-238-0464
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY172634207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY22F441Medicare PIN
E17647Medicare UPIN