MEDICARE: DR. ALEXANDER LONDON 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	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	168243	NY

General Provider Information

NPI Number	:	1821055161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDER LONDON M.D.

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD STE 400
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5107
Country	:	US
Telephone Number	:	914-984-2546
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 W MAIN ST STE 200
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-3009
Country	:	US
Telephone Number	:	631-893-6070
Fax Number	:	631-893-6465

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	06/28/2022

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