Provider Demographics
NPI:1124075643
Name:ALAN D. BUDMAN
Entity type:Organization
Organization Name:ALAN D. BUDMAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BUDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-783-2800
Mailing Address - Street 1:301 E SOMERDALE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08083-1107
Mailing Address - Country:US
Mailing Address - Phone:856-783-2800
Mailing Address - Fax:856-783-7669
Practice Address - Street 1:301 E SOMERDALE RD
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083-1107
Practice Address - Country:US
Practice Address - Phone:856-783-2800
Practice Address - Fax:856-783-7669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-29
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4527208Medicaid
NJ4527208Medicaid