Provider Demographics
NPI:1386961084
Name:MOKADAM, ALAKA (MS)
Entity type:Individual
Prefix:
First Name:ALAKA
Middle Name:
Last Name:MOKADAM
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:170 CHESTNUT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1108
Mailing Address - Country:US
Mailing Address - Phone:718-836-6600
Mailing Address - Fax:718-630-2857
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:VA NY HARBOR HEALTHCARE SYSTEM
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000297-12471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy