Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 229892 | NY |
NPI | 1417928698 |
---|---|
Provider Name | Dr. Dmitri Alden |
First Address | Poughkeepsie, NY 12601-6707 |
Second Address | Poughkeepsie, NY 12601-6707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 04/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I00505 | (02) | NY |