Provider Demographics
NPI:1992860795
Name:DOCKERAY, ALAN K SR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:K
Last Name:DOCKERAY
Suffix:SR
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 1:175 MEMORIAL HWY
Mailing Address - Street 2:SUITE 1-4
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5635
Mailing Address - Country:US
Mailing Address - Phone:914-633-5700
Mailing Address - Fax:914-633-0446
Practice Address - Street 1:175 MEMORIAL HWY
Practice Address - Street 2:SUITE 1-4
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-633-5700
Practice Address - Fax:914-633-0446
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144793NY207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AD088A0030OtherBC/BS
0D1670OtherHEALTHNET
201624POtherHIP
20340OtherAETNA
P3601338OtherOXFORD
NY00933660Medicaid
AD088A0030OtherBC/BS
0D1670OtherHEALTHNET