MEDICARE: DR. ALAN R TAJERSTEIN DPM

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	NY
2	213E00000X	Podiatrist	25MD00244000	NJ
3	332B00000X	Durable Medical Equipment & Medical Supplies

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	:	1891782587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN R TAJERSTEIN DPM

Provider Business Mailing Address
First Line	:	2802 AVENUE P
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1810
Country	:	US
Telephone Number	:	718-972-5000
Fax Number	:	718-972-3774

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	:	718-972-3774

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	11/30/2016

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