Provider Demographics
NPI:1679681639
Name:PERKELVALD, ALEXANDER (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:PERKELVALD
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 1:2320 AVENUE U
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4917
Mailing Address - Country:US
Mailing Address - Phone:718-368-3333
Mailing Address - Fax:718-934-4885
Practice Address - Street 1:1720E 14TH ST M-2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2088
Practice Address - Country:US
Practice Address - Phone:718-368-3333
Practice Address - Fax:718-934-4885
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225240207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1279340OtherAETNA HMO
NY3X6982OtherEMPIRE BLUE CROSS
NY651166987OtherMAGNACARE
NY02673605Medicaid
NY7163727OtherAETNA PPO
NY651166987OtherUNITED HEALTHCARE
NY7163727OtherAETNA PPO
NYI23698Medicare UPIN