Provider Demographics
NPI:1962602045
Name:ALESSI, ANTHONY S (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:S
Last Name:ALESSI
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARTINE AVE
Mailing Address - Street 2:1518
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-4016
Mailing Address - Country:US
Mailing Address - Phone:914-449-6720
Mailing Address - Fax:
Practice Address - Street 1:8 MARTINE AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10606-1909
Practice Address - Country:US
Practice Address - Phone:914-449-6720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0473001223S0112X
NY2476622082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02264684Medicaid