Basic Information
| Provider Information | |||||||||
| NPI: | 1396832978 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALCINDOR | ||||||||
| FirstName: | FITZGERALD | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1345 RXR PLZ | ||||||||
| Address2: | |||||||||
| City: | UNIONDALE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115561301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5164530435 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2459 MERRICK RD | ||||||||
| Address2: | |||||||||
| City: | BELLMORE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117105703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168262273 | ||||||||
| FaxNumber: | 5168262272 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 02/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 195447 | NY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 208D00000X | 195447 | NY | N | Allopathic & Osteopathic Physicians | General Practice | 2083A0300X | 195447 | NY | Y |
ID Information
| ID | Type | State | Issuer | Description | 01996881 | 05 | NY | MEDICAID |