Provider Demographics
NPI:1174598890
Name:BIENER, ALAN S
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:S
Last Name:BIENER
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 1:505 ROUTE 208
Mailing Address - Street 2:SUITE 32
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1608
Mailing Address - Country:US
Mailing Address - Phone:845-783-0667
Mailing Address - Fax:845-783-1088
Practice Address - Street 1:505 ROUTE 208
Practice Address - Street 2:SUITE 32
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1608
Practice Address - Country:US
Practice Address - Phone:845-783-0667
Practice Address - Fax:845-783-1088
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN003493213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T51140Medicare UPIN
NY0946980001Medicare NSC
P37501Medicare ID - Type Unspecified
NYP37501Medicare PIN