Provider Demographics
NPI:1811578867
Name:OOMMEN, ALVIN JOY (MD)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:JOY
Last Name:OOMMEN
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 1:58 AUTUMN CIR
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1605
Mailing Address - Country:US
Mailing Address - Phone:914-885-4186
Mailing Address - Fax:
Practice Address - Street 1:58 AUTUMN CIR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1605
Practice Address - Country:US
Practice Address - Phone:914-885-4186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program