MEDICARE: ALEXANDER SHEPPE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	280953	NY

General Provider Information

NPI Number	:	1215354170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER SHEPPE

Provider Business Mailing Address
First Line	:	1330 1ST AVE
Second Line	:	APT 409
City	:	NEW YORK
State	:	NY
Zip	:	10021-4742
Country	:	US
Telephone Number	:	917-557-0054
Fax Number	:

Provider Business Practice Location Address
First Line	:	1330 1ST AVE
Second Line	:	APT 409
City	:	NEW YORK
State	:	NY
Zip	:	10021-4742
Country	:	US
Telephone Number	:	917-557-0054
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2014
Last Update Date	:	09/07/2016

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Directions to “ ALEXANDER SHEPPE ” Practice Location

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