Healthcare Provider Details

I. General information

NPI: 1841375292
Provider Name (Legal Business Name): ALEXANDER L OKUN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 7TH AVE FL 6
NEW YORK NY
10019-6014
US

IV. Provider business mailing address

825 7TH AVE FL 6
NEW YORK NY
10019-6014
US

V. Phone/Fax

Practice location:
  • Phone: 212-651-8033
  • Fax: 929-273-7705
Mailing address:
  • Phone: 212-651-8033
  • Fax: 929-273-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number164937
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: