Alan Edward Prestia, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

101410 Issued in NY

Practice address

39 Snowdance Lane
Nesconset, NY 11767-1572

Phone

(631) 724-0654

NPI assigned

Oct 10, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1497943963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SNOWDANCE LANE",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671572",
            "telephone_number": "631-724-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SNOWDANCE LANE",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117671572",
            "telephone_number": "631-724-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTIA",
        "first_name": "ALAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-10",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "101410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Phillips
• Andrea M Pisano, LPN
• Jeanine Marie Pistilli, D.D.S.
• Adam P Postel, D.M.D
• Premier Hearing Aid Center, Inc.
• Primary Medical Care of Suffolk County, P.C.
• Psychotherapy Latino Service of Queens LCSW PLLC
• Susan M. Pusateri, RN
• Rebecca Quirindongo, LPN
• Sandra L. Qureshi

• All providers in Nesconset, NY
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.