Provider Demographics
NPI:1194801084
Name:SPECTOR, ALAN JEFFREY (DPM)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:JEFFREY
Last Name:SPECTOR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2424 BRIDGE AVE
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-4335
Mailing Address - Country:US
Mailing Address - Phone:732-899-8500
Mailing Address - Fax:732-899-8501
Practice Address - Street 1:2424 BRIDGE AVE
Practice Address - Street 2:SUITE # 2
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-4335
Practice Address - Country:US
Practice Address - Phone:732-899-8500
Practice Address - Fax:732-899-8501
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMD002028213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5006309Medicaid
NJ5006309Medicaid
NJ059257Medicare ID - Type Unspecified
NJ4166990001Medicare NSC