Provider Demographics
NPI:1851547905
Name:ALAN F. BERDAN, D.M.D., P.C.
Entity Type:Organization
Organization Name:ALAN F. BERDAN, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BERDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-702-8675
Mailing Address - Street 1:30 CENTRAL PARK SOUTH
Mailing Address - Street 2:SUITE 11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-1628
Mailing Address - Country:US
Mailing Address - Phone:212-702-8675
Mailing Address - Fax:212-702-8676
Practice Address - Street 1:30 CENTRAL PARK SOUTH
Practice Address - Street 2:SUITE 11C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-1628
Practice Address - Country:US
Practice Address - Phone:212-702-8675
Practice Address - Fax:212-702-8676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0405091261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental