Provider Demographics
NPI:1588712152
Name:BEKER, ALEXANDER
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:BEKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-5029
Mailing Address - Country:US
Mailing Address - Phone:718-743-2009
Mailing Address - Fax:
Practice Address - Street 1:3019 BRIGHTON 1ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8008
Practice Address - Country:US
Practice Address - Phone:718-743-9700
Practice Address - Fax:718-332-3511
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01974125Medicaid
50C681Medicare ID - Type Unspecified
NY01974125Medicaid