Healthcare Provider Details

I. General information

NPI: 1043770696
Provider Name (Legal Business Name): ALANA FRUAUFF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 W 181ST ST
NEW YORK NY
10033-5002
US

IV. Provider business mailing address

10 PELICAN RD
HAUPPAUGE NY
11788-1641
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-3060
  • Fax:
Mailing address:
  • Phone: 631-848-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number313800-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: