Healthcare Provider Details

I. General information

NPI: 1669445615
Provider Name (Legal Business Name): DMITRI ALDEN, MD,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 E 76TH ST
NEW YORK NY
10021-2822
US

IV. Provider business mailing address

186 E 76TH ST
NEW YORK NY
10021-2822
US

V. Phone/Fax

Practice location:
  • Phone: 212-434-6216
  • Fax: 845-452-2104
Mailing address:
  • Phone: 212-434-6216
  • Fax: 845-452-2104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number229892
License Number StateNY

VIII. Authorized Official

Name: DR. DMITRI ALDEN
Title or Position: OWNER
Credential: M.D.
Phone: 845-452-2120