Provider Demographics
NPI:1063819092
Name:EVAN ADLER, DPM
Entity Type:Organization
Organization Name:EVAN ADLER, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:732-847-2500
Mailing Address - Street 1:301 BINGHAM AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4762
Mailing Address - Country:US
Mailing Address - Phone:732-847-2500
Mailing Address - Fax:732-493-4590
Practice Address - Street 1:301 BINGHAM AVE
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4762
Practice Address - Country:US
Practice Address - Phone:732-847-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty