Healthcare Provider Details
I. General information
NPI: 1124075643
Provider Name (Legal Business Name): ALAN D. BUDMAN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/29/2006
Last Update Date: 12/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
301 E SOMERDALE RD
SOMERDALE NJ
08083-1107
US
IV. Provider business mailing address
301 E SOMERDALE RD
SOMERDALE NJ
08083-1107
US
V. Phone/Fax
- Phone: 856-783-2800
- Fax: 856-783-7669
- Phone: 856-783-2800
- Fax: 856-783-7669
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALAN
D
BUDMAN
Title or Position: OWNER
Credential: D.P.M.
Phone: 856-783-2800