Healthcare Provider Details
I. General information
NPI: 1154323012
Provider Name (Legal Business Name): BRIAN C ALESSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/11/2005
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 TURIN RD BEECHES PROFESSIONAL CAMPUS
ROME NY
13440-1900
US
IV. Provider business mailing address
7900 TURIN RD BEECHES PROFESSIONAL CAMPUS
ROME NY
13440-1900
US
V. Phone/Fax
- Phone: 315-336-3380
- Fax:
- Phone: 315-336-3380
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | NY175847-1 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 175847-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: