1952911547 NPI number — ALEXANDER RANCES, DO P.C.

Table of content: TIFFANY MCCLURE RD, CDE (NPI 1811465537)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952911547 NPI number — ALEXANDER RANCES, DO P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALEXANDER RANCES, DO P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952911547
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 270
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MASSAPEQUA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11758-0270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-264-2037
Provider Business Mailing Address Fax Number:
631-589-8650

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
305 7TH AVENUE
Provider Second Line Business Practice Location Address:
SUITE 13C
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-647-0022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2020

Additional Information

Authorized Official

Authorized Official Last Name:
RANCES
Authorized Official First Name:
ALEXANDER
Authorized Official Middle Name:
RONALD
Authorized Official Title or Position:
CHIEF MEDICAL OFFICER
Authorized Official Telephone Number:
646-647-0022

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03837827 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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