Healthcare Provider Details

I. General information

NPI: 1114902731
Provider Name (Legal Business Name): ALEXANDER Z HAAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 01/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE ST PETERS UNIVERSITY HOSPITAL RADIATION ONCOLOGY DEPT
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

579A CRANBURY RD UNIVERSITY RADIOLOGY GROUP PC
EAST BRUNSWICK NJ
08816-5426
US

V. Phone/Fax

Practice location:
  • Phone: 732-745-8530
  • Fax: 732-745-7607
Mailing address:
  • Phone: 732-390-0040
  • Fax: 732-390-1856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number25MA02743400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: