Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25MA08118800 | NJ |
Y | 208600000X | Surgeon | 25MA08118800 | NJ |
N | 2086S0102X | Surgical Critical Care | 25MA08118800 | NJ |
NPI | 1346264116 |
---|---|
Provider Name | Dr. Alexander L Shifrin |
First Address | Neptune, NJ 07753-4859 |
Second Address | Neptune, NJ 07753-4859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 31/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I38097 | (02) |