Provider Demographics
NPI:1053723452
Name:ALEVI, RANDY (DO)
Entity type:Individual
Prefix:DR
First Name:RANDY
Middle Name:
Last Name:ALEVI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PADDOCK CT
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1147
Mailing Address - Country:US
Mailing Address - Phone:516-458-6073
Mailing Address - Fax:
Practice Address - Street 1:1575 HILLSIDE AVE STE 202
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2501
Practice Address - Country:US
Practice Address - Phone:516-616-0456
Practice Address - Fax:516-616-0456
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY39020000X208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics