Provider Demographics
NPI:1184725863
Name:HEYMANN, ALAN DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:DOUGLAS
Last Name:HEYMANN
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 1:122 E 76TH ST OFC 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2833
Mailing Address - Country:US
Mailing Address - Phone:212-628-8771
Mailing Address - Fax:
Practice Address - Street 1:122 E 76TH ST OFC 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2833
Practice Address - Country:US
Practice Address - Phone:212-628-8771
Practice Address - Fax:212-628-7721
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097908208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY569001Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
NYB16645Medicare UPIN