Provider Demographics
NPI:1902196603
Name:ALEX, DEEPU (MD)
Entity Type:Individual
Prefix:DR
First Name:DEEPU
Middle Name:
Last Name:ALEX
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 1:1233 YORK AVE
Mailing Address - Street 2:# 16-0
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6306
Mailing Address - Country:US
Mailing Address - Phone:202-386-8828
Mailing Address - Fax:
Practice Address - Street 1:1233 YORK AVE
Practice Address - Street 2:# 16-0
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6306
Practice Address - Country:US
Practice Address - Phone:202-386-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program