Individual
DR. ALAN B ETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6080 JERICHO TPKE, COMMACK, NY 11725-2850
(631) 364-9119
Mailing address
6080 JERICHO TPKE, COMMACK, NY 11725-2850
(631) 364-9119
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
169005
NY
2084N0600X
Clinical Neurophysiology Physician
169005
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01346749
—
NY
Enumeration date
01/21/2006
Last updated
06/21/2019
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