MEDICARE: KENNETH ALPER M.D.

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	2084P0800X	Psychiatry Physician	164228	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366550816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH ALPER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1838
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10156-1838
Country	:	US
Telephone Number	:	212-981-7274
Fax Number	:	212-209-3252

Provider Business Practice Location Address
First Line	:	150 E 58TH ST
Second Line	:	25TH FL
City	:	NEW YORK
State	:	NY
Zip	:	10155-0002
Country	:	US
Telephone Number	:	212-966-3506
Fax Number	:	212-409-8902

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	09/28/2010

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