Healthcare Provider Details

I. General information

NPI: 1336788397
Provider Name (Legal Business Name): GEORGIO ALFECHE DANO NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2019
Last Update Date: 03/14/2025
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 EAST 57TH STREET
NEW YORK NY
10022
US

IV. Provider business mailing address

21 CABOT PL
STATEN ISLAND NY
10305-3007
US

V. Phone/Fax

Practice location:
  • Phone: 212-600-2000
  • Fax:
Mailing address:
  • Phone: 646-243-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344044-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: