Provider Demographics
NPI:1215997531
Name:ROSS, ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2426 EASTCHESTER RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-5947
Mailing Address - Country:US
Mailing Address - Phone:718-708-5650
Mailing Address - Fax:718-708-5619
Practice Address - Street 1:2426 EASTCHESTER RD
Practice Address - Street 2:SUITE 208
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5947
Practice Address - Country:US
Practice Address - Phone:718-708-5650
Practice Address - Fax:718-708-5619
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY167788207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01517064Medicaid
NY01517064Medicaid
NYD67689Medicare UPIN