MEDICARE: ANTHONY S. ALESSI DMD, 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	2476621	NY

General Provider Information

NPI Number	:	1619286887
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANTHONY S. ALESSI DMD, MD

Provider Business Mailing Address
First Line	:	4 MARTINE AVE
Second Line	:	APT # 1518
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-4016
Country	:	US
Telephone Number	:	914-261-5644
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 MARTINE AVE
Second Line	:	APT # 1518
City	:	WHITE PLAINS
State	:	NY
Zip	:	10606-4016
Country	:	US
Telephone Number	:	914-261-5644
Fax Number	:

Authorized Official
Title or Position	:	PT ACCOUNTS
Name	:	MATHEW JAMES
Credential	:
Telephone Number	:	631-827-8159

Provider Enumeration Date	:	10/05/2010
Last Update Date	:	10/05/2010

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