Provider Demographics
NPI:1538386867
Name:ALAN ROSENZWEIG DO PA
Entity type:Organization
Organization Name:ALAN ROSENZWEIG DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-829-8146
Mailing Address - Street 1:917 CINNAMINSON AVE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NJ
Mailing Address - Zip Code:08065-1817
Mailing Address - Country:US
Mailing Address - Phone:856-829-8146
Mailing Address - Fax:856-786-4442
Practice Address - Street 1:917 CINNAMINSON AVE
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NJ
Practice Address - Zip Code:08065-1817
Practice Address - Country:US
Practice Address - Phone:856-829-8146
Practice Address - Fax:856-786-4442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3035905Medicaid
NJ3035905Medicaid
117531Medicare ID - Type Unspecified