Provider Demographics
NPI:1285620849
Name:ADLER, BARRY (DMD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:ADLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4723
Mailing Address - Country:US
Mailing Address - Phone:201-433-7336
Mailing Address - Fax:201-433-9752
Practice Address - Street 1:815 MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4723
Practice Address - Country:US
Practice Address - Phone:201-433-7336
Practice Address - Fax:201-433-9752
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10778122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ09000000500OtherAMERICHOICE