Provider Demographics
NPI:1801967500
Name:ALCAIDE, ALEJANDRO (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:ALCAIDE
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 1:4018 76TH ST
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1018
Mailing Address - Country:US
Mailing Address - Phone:718-779-6800
Mailing Address - Fax:718-779-7598
Practice Address - Street 1:4018 76TH ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1018
Practice Address - Country:US
Practice Address - Phone:718-779-6800
Practice Address - Fax:718-779-7598
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196651207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01723817Medicaid
NYG39654Medicare UPIN
NY01723817Medicaid