Healthcare Provider Details

I. General information

NPI: 1164462438
Provider Name (Legal Business Name): MARK MOSHE ALPERIN PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 09/13/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1578 E 36TH ST
BROOKLYN NY
11234-3416
US

IV. Provider business mailing address

1578 E 36TH ST
BROOKLYN NY
11234-3416
US

V. Phone/Fax

Practice location:
  • Phone: 516-229-1917
  • Fax: 585-326-6008
Mailing address:
  • Phone: 516-229-1917
  • Fax: 718-260-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number233342
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number010522
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: