Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS039483 | PA |
NPI | 1104195619 |
---|---|
Provider Name | Dr. Peter Alfano |
First Address | New York, NY 10028-7008 |
Second Address | Brooklyn, NY 11212-3139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2011 |
Last Update Date | 23/01/2017 |