Healthcare Provider Details

I. General information

NPI: 1528610656
Provider Name (Legal Business Name): ALVEENA ALTAF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CORNELIA ST STE 303
PLATTSBURGH NY
12901-2318
US

IV. Provider business mailing address

210 CORNELIA ST STE 303
PLATTSBURGH NY
12901-2318
US

V. Phone/Fax

Practice location:
  • Phone: 518-314-3460
  • Fax: 518-314-3464
Mailing address:
  • Phone: 518-314-3460
  • Fax: 518-314-3464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number339195
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: