Provider Demographics
NPI:1194804443
Name:ADLER, SCOTT LEE (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LEE
Last Name:ADLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2997 PRINCETON PIKE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-882-2299
Mailing Address - Fax:609-538-8230
Practice Address - Street 1:2997 PRINCETON PIKE
Practice Address - Street 2:SUITE 301
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-3224
Practice Address - Country:US
Practice Address - Phone:609-882-2299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44361207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2714604Medicaid
NJ2714604Medicaid