Provider Demographics
NPI:1023051497
Name:NEMETH, ALAN ISAAC (DO)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:ISAAC
Last Name:NEMETH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13700 1378
Mailing Address - Street 2:BROOKHAVEN MEMORIAL HOSPITAL ER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19191-1378
Mailing Address - Country:US
Mailing Address - Phone:800-666-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:101 HOSPITAL ROAD
Practice Address - Street 2:MEDICAL CENTER
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-687-2953
Practice Address - Fax:610-617-6280
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191299207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G58705Medicare UPIN
NY588071Medicare ID - Type Unspecified