Provider Demographics
NPI:1952319139
Name:SIEGAL, ALAN P (MD)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:P
Last Name:SIEGAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:60 WASHINGTON AVENUE
Mailing Address - Street 2:SUITE 203 GERIATRIC AND ADULT PSYCHIATRY LLC
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3272
Mailing Address - Country:US
Mailing Address - Phone:203-288-0414
Mailing Address - Fax:203-288-3655
Practice Address - Street 1:60 WASHINGTON AVENUE
Practice Address - Street 2:SUITE 203 GERIATRIC AND ADULT PSYCHIATRY LLC
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3272
Practice Address - Country:US
Practice Address - Phone:203-288-0414
Practice Address - Fax:203-288-3655
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0226952084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001226952Medicaid
D88835Medicare UPIN
CT260002290Medicare ID - Type Unspecified