Provider Demographics
NPI:1811972011
Name:SIEGEL, ALAN NEIL (DC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:NEIL
Last Name:SIEGEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2023
Mailing Address - Country:US
Mailing Address - Phone:516-759-5005
Mailing Address - Fax:516-759-1509
Practice Address - Street 1:154 FOREST AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2023
Practice Address - Country:US
Practice Address - Phone:516-759-5005
Practice Address - Fax:516-759-1509
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT31763Medicare UPIN
NYX004391Medicare ID - Type Unspecified
NY16167Medicare ID - Type Unspecified
NYX26462Medicare PIN