Provider Demographics
NPI:1316050206
Name:ALAN S BAILER DO PA
Entity type:Organization
Organization Name:ALAN S BAILER DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALL OFFICERS
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BAILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-845-5226
Mailing Address - Street 1:1010 HESSIAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08063
Mailing Address - Country:US
Mailing Address - Phone:856-845-5226
Mailing Address - Fax:
Practice Address - Street 1:1010 HESSIAN AVENUE
Practice Address - Street 2:
Practice Address - City:NATIONAL PARK
Practice Address - State:NJ
Practice Address - Zip Code:08063
Practice Address - Country:US
Practice Address - Phone:856-845-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty