Provider Demographics
NPI:1093953762
Name:ALAN M. TELL, MD
Entity Type:Organization
Organization Name:ALAN M. TELL, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-487-2777
Mailing Address - Street 1:140 PROSPECT AVE.
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2260
Mailing Address - Country:US
Mailing Address - Phone:201-487-2777
Mailing Address - Fax:201-487-1369
Practice Address - Street 1:140 PROSPECT AVE.
Practice Address - Street 2:SUITE 7
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2260
Practice Address - Country:US
Practice Address - Phone:201-487-2777
Practice Address - Fax:201-487-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04061100207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty