Healthcare Provider Details

I. General information

NPI: 1740234160
Provider Name (Legal Business Name): ALEXANDER FRUCHTER II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 07/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 EAST MAIN ST #4
MIDDLETOWN NY
10940-2578
US

IV. Provider business mailing address

450 EAST MAIN ST #4 VITAL SIGNS MEDICAL ASSOC
MIDDLETOWN NY
10940-2578
US

V. Phone/Fax

Practice location:
  • Phone: 845-381-5109
  • Fax: 845-531-4882
Mailing address:
  • Phone: 845-381-5109
  • Fax: 845-531-4882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number168696
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number168696
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: