Healthcare Provider Details

I. General information

NPI: 1003865601
Provider Name (Legal Business Name): ALAN REMDE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 06/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 MEMORIAL PKWY STE 300
PHILLIPSBURG NJ
08865
US

IV. Provider business mailing address

755 MEMORIAL PKWY STE 300
PHILLIPSBURG NJ
08865-2748
US

V. Phone/Fax

Practice location:
  • Phone: 908-454-6303
  • Fax: 866-281-6023
Mailing address:
  • Phone: 908-454-6303
  • Fax: 866-281-6023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberMA48359
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number275333-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number275333-1
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA48359
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: