=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194804443
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SCOTT LEE ADLER M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2006
-----------------------------------------------------
Last Update Date | 12/14/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2997 PRINCETON PIKE SUITE 301
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648-3224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-882-2299
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2997 PRINCETON PIKE SUITE 301
-----------------------------------------------------
City | LAWRENCEVILLE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-882-2299
-----------------------------------------------------
Fax | 609-538-8230
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 44361
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------