Provider Demographics
NPI:1881626737
Name:WEI, ALICE (MD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:
Last Name:WEI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 E 16TH ST
Mailing Address - Street 2:SUITE 12A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3707
Mailing Address - Country:US
Mailing Address - Phone:212-281-8200
Mailing Address - Fax:212-281-8301
Practice Address - Street 1:2615 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030-1705
Practice Address - Country:US
Practice Address - Phone:212-281-8200
Practice Address - Fax:212-281-8301
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY229768207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02645967Medicaid
I18746Medicare UPIN
NY7X0541Medicare PIN