Healthcare Provider Details

I. General information

NPI: 1093019556
Provider Name (Legal Business Name): DALE ALEXANDER, D.O. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 12/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 CONCORD AVE
OCEANSIDE NY
11572-5400
US

IV. Provider business mailing address

292 CONCORD AVE
OCEANSIDE NY
11572-5400
US

V. Phone/Fax

Practice location:
  • Phone: 516-304-5901
  • Fax: 516-502-4492
Mailing address:
  • Phone: 516-304-5901
  • Fax: 516-502-4492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number229782
License Number StateNY

VIII. Authorized Official

Name: DR. DALE ALEXANDER
Title or Position: OWNER
Credential: D.O.
Phone: 516-304-5901