Individual
DR. ALEXANDER PERETZ LOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
334 DERBY AVE, WOODMERE, NY 11598-2821
(718) 207-9920
Mailing address
334 DERBY AVE, WOODMERE, NY 11598-2821
(718) 207-9920
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
253628
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A300050882
MEDICARE PTAN
NY
Enumeration date
06/06/2008
Last updated
12/18/2018
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