Provider Demographics
NPI:1548367196
Name:REYNALDO H. ALONSO, M.D.P.C.
Entity type:Organization
Organization Name:REYNALDO H. ALONSO, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P.C.
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:H
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-231-7872
Mailing Address - Street 1:345 W END AVE
Mailing Address - Street 2:#4A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-6825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2426 EASTCHESTER RD
Practice Address - Street 2:2ND FLOOR SUITE 204
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-5916
Practice Address - Country:US
Practice Address - Phone:718-231-7872
Practice Address - Fax:718-231-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191962-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty