Organization
ALAN L NISSENBAUM MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN L NISSENBAUM MD (PRESIDENT)
(516) 877-4013
Entity
Organization
Contact information
Practice address
3915 AVENUE V # 104, BROOKLYN, NY 11234-5156
(718) 252-8440
Mailing address
2514 E 65TH ST, BROOKLYN, NY 11234-6927
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
09/19/2007
Last updated
09/19/2007
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