Healthcare Provider Details

I. General information

NPI: 1255496089
Provider Name (Legal Business Name): ALESSANDRO FICHERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 YORK AVE # 172
NEW YORK NY
10021-5304
US

IV. Provider business mailing address

1315 YORK AVE # 172
NEW YORK NY
10021-5304
US

V. Phone/Fax

Practice location:
  • Phone: 469-800-7180
  • Fax:
Mailing address:
  • Phone: 469-800-7180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number332325
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: