Healthcare Provider Details

I. General information

NPI: 1700975752
Provider Name (Legal Business Name): ALAN DUNN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 10/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3252 ROUTE 35 N
LAVALLETTE NJ
08735-1531
US

IV. Provider business mailing address

6 ROSWELL TER
GLEN RIDGE NJ
07028-1610
US

V. Phone/Fax

Practice location:
  • Phone: 732-830-9333
  • Fax:
Mailing address:
  • Phone: 973-783-5039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number25MA03268700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: