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General NPI Number Information
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NPI Number | 1942297866
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Entity Type | Individual
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Provider Name | ALAN JAY MUSHNICK MD
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Gender | Male
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Dates
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Enumeration Date | 10/05/2005
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 502 CENTENNIAL BLVD STE 3
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City | VOORHEES
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State | NJ
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Zip | 08043-9544
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Country | US
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Telephone | 856-772-1600
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Fax | 856-772-9031
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-355-0340
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Fax | 856-355-0330
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 25MA04159900
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License Number State | NJ
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