Healthcare Provider Details

I. General information

NPI: 1194900365
Provider Name (Legal Business Name): ALEXANDER LLINAS M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 06/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 NESCONSET HWY SUITE 107
EAST SETAUKET NY
11733-3327
US

IV. Provider business mailing address

3400 NESCONSET HWY SUITE 107
EAST SETAUKET NY
11733-3327
US

V. Phone/Fax

Practice location:
  • Phone: 631-751-2020
  • Fax:
Mailing address:
  • Phone: 631-751-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number246078
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: