Healthcare Provider Details

I. General information

NPI: 1992871636
Provider Name (Legal Business Name): ALAN N MEISEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 CROOKED HILL RD BUCKMAN CENTER BLDG 47
W BRENTWOOD NY
11717-1087
US

IV. Provider business mailing address

1 BRANDYWINE DR
SETAUKET NY
11717-1087
US

V. Phone/Fax

Practice location:
  • Phone: 631-761-2581
  • Fax: 631-761-2244
Mailing address:
  • Phone: 631-761-2581
  • Fax: 631-761-2244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number125183
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: