Healthcare Provider Details

I. General information

NPI: 1548228232
Provider Name (Legal Business Name): NELSON ALCARAZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16303 HORACE HARDING EXPY FL 3
FRESH MEADOWS NY
11365-1449
US

IV. Provider business mailing address

660 WHITE PLAINS RD STE 400
TARRYTOWN NY
10591-5107
US

V. Phone/Fax

Practice location:
  • Phone: 718-445-5100
  • Fax: 718-358-1044
Mailing address:
  • Phone: 914-984-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number198212
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number198212
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: