Healthcare Provider Details

I. General information

NPI: 1437180775
Provider Name (Legal Business Name): ALAN R DAYAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 04/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E 14TH ST SUITE 419
NEW YORK NY
10003-4201
US

IV. Provider business mailing address

310 E 14TH ST SUITE 419
NEW YORK NY
10003-4201
US

V. Phone/Fax

Practice location:
  • Phone: 212-677-2000
  • Fax: 212-353-5754
Mailing address:
  • Phone: 212-677-2000
  • Fax: 212-353-5754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number194610
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: