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Organization

ALAN ANTONELLI M.D. PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN ANTONELLI M.D. (PRESIDENT)
(718) 217-1414
Entity
Organization

Contact information

Practice address
18904 UNION TPKE, FRESH MEADOWS, NY 11366-1862
(718) 217-1414
(718) 217-1669
Mailing address
18904 UNION TPKE, QUEENS, FRESH MEADOWS, NY 11366-1862
(718) 217-1414
(718) 217-1669

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063565950
NPI
01
132116 NEW YORK
MEDICAL LICENSE
Enumeration date
11/30/2015
Last updated
03/07/2023
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