Provider Demographics
NPI:1831166545
Name:ALPERT, SAMUEL G (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:G
Last Name:ALPERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5700 W GENESEE ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-3200
Mailing Address - Country:US
Mailing Address - Phone:315-488-1601
Mailing Address - Fax:315-488-0047
Practice Address - Street 1:5700 W GENESEE ST
Practice Address - Street 2:SUITE 112
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-3200
Practice Address - Country:US
Practice Address - Phone:315-488-1601
Practice Address - Fax:315-488-0047
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2014-04-23
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Provider Licenses
StateLicense IDTaxonomies
NY218960-01207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02428206Medicaid
NYBA0254Medicare ID - Type UnspecifiedGROUP PROVIDER #
NYH89702Medicare UPIN