Provider Demographics
NPI:1093898082
Name:MCGOWAN, ALEXANDER (OD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:MCGOWAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1633
Mailing Address - Country:US
Mailing Address - Phone:908-806-8882
Mailing Address - Fax:908-806-3767
Practice Address - Street 1:14 STATE ROUTE 31
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1633
Practice Address - Country:US
Practice Address - Phone:908-806-8882
Practice Address - Fax:908-806-3767
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00506000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6374409Medicaid
NJU01607Medicare UPIN
NJ6374409Medicaid