Provider Demographics
NPI:1275582017
Name:ZUBROW, ALAN BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:BRUCE
Last Name:ZUBROW
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 1:1431 BARTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-2823
Mailing Address - Country:US
Mailing Address - Phone:215-641-9682
Mailing Address - Fax:
Practice Address - Street 1:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - Street 2:3601 A ST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-5202
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020443E2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006235450007Medicaid
PA160830Medicare ID - Type Unspecified
PA0006235450007Medicaid