Healthcare Provider Details

I. General information

NPI: 1063406981
Provider Name (Legal Business Name): ALFRED JOEL NADEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 EAST 80TH ST
NEW YORK NY
10075-0306
US

IV. Provider business mailing address

140 EAST 80TH STREET
NEW YORK NY
10075-0306
US

V. Phone/Fax

Practice location:
  • Phone: 212-772-0600
  • Fax: 212-517-8028
Mailing address:
  • Phone: 212-772-0600
  • Fax: 212-517-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number099763
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number099763
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: