Healthcare Provider Details
I. General information
NPI: 1366715351
Provider Name (Legal Business Name): ARIK ALPER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/22/2012
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 YORK ST # T-209 YALE-NEW HAVEN HOSPITAL
NEW HAVEN CT
06510-3220
US
IV. Provider business mailing address
20 YORK ST # T-209 YALE-NEW HAVEN HOSPITAL
NEW HAVEN CT
06510-3220
US
V. Phone/Fax
- Phone: 203-688-2259
- Fax: 203-688-5599
- Phone: 203-688-2259
- Fax: 203-688-5599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0206X |
| Taxonomy | Pediatric Gastroenterology Physician |
| License Number | 54273 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: