Provider Demographics
NPI:1396816468
Name:LAWIT, ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:LAWIT
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 1:1010 19TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4492
Mailing Address - Country:US
Mailing Address - Phone:609-314-8330
Mailing Address - Fax:
Practice Address - Street 1:127 N BROAD ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1718
Practice Address - Country:US
Practice Address - Phone:856-845-8077
Practice Address - Fax:856-845-1295
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-12
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG87222207Q00000X
NJ25MA03187600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00303075OtherRR MEDICARE
NJLA179652Medicare ID - Type UnspecifiedMEDICARE
NJC53743Medicare UPIN
NJP00303075OtherRR MEDICARE