Provider Demographics
NPI:1740234160
Name:FRUCHTER, ALEXANDER II (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:FRUCHTER
Suffix:II
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 1:450 EAST MAIN ST #4
Mailing Address - Street 2:VITAL SIGNS MEDICAL ASSOC
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-2578
Mailing Address - Country:US
Mailing Address - Phone:845-381-5109
Mailing Address - Fax:845-531-4882
Practice Address - Street 1:450 EAST MAIN ST #4
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2578
Practice Address - Country:US
Practice Address - Phone:845-381-5109
Practice Address - Fax:845-531-4882
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168696207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01172527Medicaid
NY200050512OtherMVP
434CK1OtherEMPIRE BCBS
NY01172527Medicaid