Provider Demographics
NPI:1962469445
Name:ALIPRANDIS, ELIAS T (MD)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:T
Last Name:ALIPRANDIS
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 1:8721 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5109
Mailing Address - Country:US
Mailing Address - Phone:718-680-1500
Mailing Address - Fax:718-680-5550
Practice Address - Street 1:8721 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5109
Practice Address - Country:US
Practice Address - Phone:718-680-1500
Practice Address - Fax:718-680-5550
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235436207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02658088Medicaid
NY02658088Medicaid
NYA400069137Medicare PIN