Individual
DR. ALAN LEON NISSENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3915 AVENUE V STE 104, BROOKLYN, NY 11234-5156
(718) 252-8440
Mailing address
2152 RALPH AVE # 428, BROOKLYN, NY 11234-5406
(718) 998-7363
(718) 998-7592
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
177636
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01851147
—
NY
Enumeration date
02/16/2007
Last updated
09/01/2022
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