Provider Demographics
NPI:1033595855
Name:ALGER, JON PATRICK (MS, CNS, LDN)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:PATRICK
Last Name:ALGER
Suffix:
Gender:M
Credentials:MS, CNS, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 W PRESTON ST
Mailing Address - Street 2:101
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5702
Mailing Address - Country:US
Mailing Address - Phone:202-556-5286
Mailing Address - Fax:
Practice Address - Street 1:4204 HECKEL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-6321
Practice Address - Country:US
Practice Address - Phone:410-900-8010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCNU100000171133N00000X
MDDX3730133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist