Healthcare Provider Details

I. General information

NPI: 1619286887
Provider Name (Legal Business Name): ANTHONY S. ALESSI DMD, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2010
Last Update Date: 10/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MARTINE AVE APT # 1518
WHITE PLAINS NY
10606-4016
US

IV. Provider business mailing address

4 MARTINE AVE APT # 1518
WHITE PLAINS NY
10606-4016
US

V. Phone/Fax

Practice location:
  • Phone: 914-261-5644
  • Fax:
Mailing address:
  • Phone: 914-261-5644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2476621
License Number StateNY

VIII. Authorized Official

Name: MATHEW JAMES
Title or Position: PT ACCOUNTS
Credential:
Phone: 631-827-8159