Healthcare Provider Details

I. General information

NPI: 1023110533
Provider Name (Legal Business Name): ALON MEIR PRYWES D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 5TH AVE
NEW YORK NY
10003-4338
US

IV. Provider business mailing address

33 5TH AVE
NEW YORK NY
10003-4338
US

V. Phone/Fax

Practice location:
  • Phone: 212-982-4439
  • Fax: 212-677-1907
Mailing address:
  • Phone: 212-982-4439
  • Fax: 212-677-1907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number036360
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: