Provider Demographics
NPI:1225304496
Name:ETINGER, ALEKSEY (DO)
Entity type:Individual
Prefix:
First Name:ALEKSEY
Middle Name:
Last Name:ETINGER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8713 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7847
Mailing Address - Country:US
Mailing Address - Phone:718-971-9509
Mailing Address - Fax:718-971-1698
Practice Address - Street 1:8713 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7847
Practice Address - Country:US
Practice Address - Phone:718-971-9509
Practice Address - Fax:718-971-1698
Is Sole Proprietor?:No
Enumeration Date:2012-03-31
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB11857000207RC0200X
NY280493207RN0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology