Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 275333-1 | NY |
N | 207Q00000X | Family Doctor | MA48359 | NJ |
N | 207QS0010X | Family Doctor - Sports Medicine | 275333-1 | NY |
N | 207QS0010X | Family Doctor - Sports Medicine | MA48359 | NJ |
NPI | 1003865601 |
---|---|
Provider Name | Dr. Alan Remde |
First Address | Phillipsburg, NJ 08865-2748 |
Second Address | Phillipsburg, NJ 08865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 22/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5635101 | (05) | NJ |
E36222 | (02) |