Healthcare Provider Details

I. General information

NPI: 1124048707
Provider Name (Legal Business Name): ALEXANDER BEYLINSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 06/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1870 RICHMOND RD
STATEN ISLAND NY
10306-2553
US

IV. Provider business mailing address

1870 RICHMOND RD
STATEN ISLAND NY
10306-2553
US

V. Phone/Fax

Practice location:
  • Phone: 718-351-2192
  • Fax: 718-980-6012
Mailing address:
  • Phone: 718-351-2192
  • Fax: 718-980-6012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number227515
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: