Healthcare Provider Details

I. General information

NPI: 1033595855
Provider Name (Legal Business Name): JON PATRICK ALGER MS, CNS, LDN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4204 HECKEL AVE
BALTIMORE MD
21206-6321
US

IV. Provider business mailing address

21 W PRESTON ST 101
BALTIMORE MD
21201-5702
US

V. Phone/Fax

Practice location:
  • Phone: 410-900-8010
  • Fax:
Mailing address:
  • Phone: 202-556-5286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU100000171
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX3730
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: