Provider Demographics
NPI:1780651166
Name:SHIFRIN, ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:SHIFRIN
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 1:340 E 64TH ST
Mailing Address - Street 2:SUITE # 3S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7503
Mailing Address - Country:US
Mailing Address - Phone:212-888-3928
Mailing Address - Fax:718-238-4706
Practice Address - Street 1:9920 4TH AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8333
Practice Address - Country:US
Practice Address - Phone:718-238-4707
Practice Address - Fax:718-238-4706
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203551207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01708429Medicaid
NYWES811Medicare ID - Type Unspecified
NYG42193Medicare UPIN