Provider Demographics
NPI:1275873358
Name:R. ALAN HENSELER, MD, P.C.
Entity Type:Organization
Organization Name:R. ALAN HENSELER, MD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HENSSELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-267-2715
Mailing Address - Street 1:21 PERRY ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-9446
Mailing Address - Country:US
Mailing Address - Phone:973-267-2715
Mailing Address - Fax:973-326-6768
Practice Address - Street 1:21 PERRY ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-9446
Practice Address - Country:US
Practice Address - Phone:973-267-2715
Practice Address - Fax:973-326-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA034256002086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC52965Medicare UPIN