Provider Demographics
NPI:1689673147
Name:MESSINA, ALBERT V (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:V
Last Name:MESSINA
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 1:525 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8141
Mailing Address - Country:US
Mailing Address - Phone:212-888-1000
Mailing Address - Fax:212-888-0188
Practice Address - Street 1:525 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-8141
Practice Address - Country:US
Practice Address - Phone:212-888-1000
Practice Address - Fax:212-888-0188
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103949-12085N0700X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00180603Medicaid
625151Medicare PIN
C11567Medicare UPIN