MEDICARE: DR. REYNALDO HILARIO ALONSO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	191962-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004611253	OTHER	NY	AETNA
2	0482499	OTHER		AETNA HMO
3	17J072	OTHER	NY	BC/BS COMMERCIAL
4	1P0001	OTHER	NY	PHS
5	2505001	OTHER	NY	GHI
6	133884701	OTHER	NY	COMMERCIAL
7	191962-NY	OTHER	NY	1199 BENEFITS FUND
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	GP292	OTHER	NY	OXFORD
10	0622006	OTHER		CIGNA
11	191962	OTHER	NY	HIP HEALTH PLANS OF NY

General Provider Information

NPI Number	:	1295735553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REYNALDO HILARIO ALONSO MD

Provider Business Mailing Address
First Line	:	4950 W SUNSET BLVD
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5822
Country	:	US
Telephone Number	:	800-954-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2426 EASTCHESTER RD
Second Line	:	204
City	:	BRONX
State	:	NY
Zip	:	10469-5947
Country	:	US
Telephone Number	:	718-231-7872
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/28/2021

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