MEDICARE: ALEXANDER ONOPCHENKO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MA47320	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649296732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDER ONOPCHENKO MD

Provider Business Mailing Address
First Line	:	111 IONA AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-2115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 ENGLISH CREEK AVE
Second Line	:	BUILDING 200, SUITE 222
City	:	EGG HARBOR TWP
State	:	NJ
Zip	:	08234-5549
Country	:	US
Telephone Number	:	609-407-2332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	03/01/2008

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