Provider Demographics
NPI:1316472194
Name:ALDO ALLEVA, MD PLLC
Entity type:Organization
Organization Name:ALDO ALLEVA, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-807-1608
Mailing Address - Street 1:298 AINSLIE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3816
Mailing Address - Country:US
Mailing Address - Phone:516-807-1608
Mailing Address - Fax:
Practice Address - Street 1:36 SKILLMAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-2204
Practice Address - Country:US
Practice Address - Phone:516-807-1608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
NY2854131261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty