MEDICARE: ALAN TAJERSTEIN 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	213E00000X	Podiatrist	N004639-1	NY
2	332B00000X	Durable Medical Equipment & Medical Supplies	N004639-1	NY

General Provider Information

NPI Number	:	1528403193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN TAJERSTEIN M D

Provider Business Mailing Address
First Line	:	2802 AVENUE P
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1810
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1468 E 10TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-6504
Country	:	US
Telephone Number	:	718-972-5000
Fax Number	:	719-972-3774

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALAN TAJERSTEIN
Credential	:	D.P.M.
Telephone Number	:	718-972-5000

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	05/08/2013

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