Provider Demographics
NPI:1396803284
Name:ALCHERMES, STEPHEN L (DPM)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:L
Last Name:ALCHERMES
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MEDICAL PLAZA
Mailing Address - Street 2:SUITE 306
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542
Mailing Address - Country:US
Mailing Address - Phone:516-676-1116
Mailing Address - Fax:516-676-2710
Practice Address - Street 1:10 MEDICAL PLAZA
Practice Address - Street 2:SUITE 306
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542
Practice Address - Country:US
Practice Address - Phone:516-676-1116
Practice Address - Fax:516-676-2710
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYN002316213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00415063Medicaid
NY00415063Medicaid
T50731Medicare UPIN