Provider Demographics
NPI:1649271255
Name:BECKER, ALFRED (MD)
Entity type:Individual
Prefix:
First Name:ALFRED
Middle Name:
Last Name:BECKER
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 1:155 CRYSTAL RUN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-4028
Mailing Address - Country:US
Mailing Address - Phone:845-703-6999
Mailing Address - Fax:845-703-6297
Practice Address - Street 1:2 CENTEROCK RD
Practice Address - Street 2:
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-2215
Practice Address - Country:US
Practice Address - Phone:845-703-6999
Practice Address - Fax:845-703-6297
Is Sole Proprietor?:No
Enumeration Date:2005-08-04
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090954207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400130625Medicare PIN
NY0909541OtherHIP#
NY132749853-002OtherPRUDENTIAL#
NY393682OtherMVP#
NY4265280OtherAETNA#
NY76612OtherNYLCARE#
NYC10662Medicare UPIN
NY132749853-008OtherCIGNA#
NY454912OtherAUSHC#
NY00144596Medicaid
NY000000007856OtherGHI#
NY132749853OtherTAX ID#
NY506591OtherBC/BS OF NY#
NY50659ZT1Z1Medicare PIN
NY003482OtherCONNECTICARE#
NY040706000001OtherFIDELIS#
NYRS319OtherOXFORD#
NJ5172900Medicaid
NY1000015980OtherAFFINITY#