Healthcare Provider Details

I. General information

NPI: 1528093879
Provider Name (Legal Business Name): ALAN S WEINSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 MADISON AVE 4TH FLOOR STOKES BUILDING VIRTUA MEMORIAL HOSPITAL
MOUNT HOLLY NJ
08060-2038
US

IV. Provider business mailing address

175 MADISON AVE 4TH FLOOR STOKES BUILDING VIRTUA MEMORIAL HOSPITAL
MOUNT HOLLY NJ
08060-2038
US

V. Phone/Fax

Practice location:
  • Phone: 609-702-1900
  • Fax: 609-702-8455
Mailing address:
  • Phone: 609-702-1900
  • Fax: 609-702-8455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMA036095
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: