Provider Demographics
NPI:1003090275
Name:ZASLAVSKY, ALEXANDR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDR
Middle Name:
Last Name:ZASLAVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:2171 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2733
Practice Address - Country:US
Practice Address - Phone:856-406-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253888207R00000X
MDD0075345207R00000X
NJ25MA09608800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ414828ZPCNMedicare PIN
MD279755YVZMedicare PIN
MD350732YWVZMedicare PIN
MD279755ZDDBMedicare PIN