Provider Demographics
NPI:1144219155
Name:GOLDSTEIN, ALAN F (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:F
Last Name:GOLDSTEIN
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:MULTI-CARE
Mailing Address - Street 2:100 COMMERCE PLACE
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07020
Mailing Address - Country:US
Mailing Address - Phone:201-886-9449
Mailing Address - Fax:
Practice Address - Street 1:MULTI-CARE
Practice Address - Street 2:100 COMMERCE PLACE
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066
Practice Address - Country:US
Practice Address - Phone:732-499-0606
Practice Address - Fax:732-499-8128
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA032454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ431964NA8Medicare PIN
E53084Medicare UPIN