Provider Demographics
NPI:1063406981
Name:NADEL, ALFRED JOEL (MD)
Entity type:Individual
Prefix:MR
First Name:ALFRED
Middle Name:JOEL
Last Name:NADEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 EAST 80TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0306
Mailing Address - Country:US
Mailing Address - Phone:212-772-0600
Mailing Address - Fax:212-517-8028
Practice Address - Street 1:140 EAST 80TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0306
Practice Address - Country:US
Practice Address - Phone:212-772-0600
Practice Address - Fax:212-517-8028
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099763207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00170407Medicaid
NYB105076Medicare UPIN
NY475381Medicare ID - Type Unspecified
NYB15076Medicare UPIN