Provider Demographics
NPI:1417029588
Name:BREWSTER, ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:BREWSTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 PASSAIC AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4762
Mailing Address - Country:US
Mailing Address - Phone:973-777-4141
Mailing Address - Fax:973-777-4242
Practice Address - Street 1:141 PASSAIC AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4762
Practice Address - Country:US
Practice Address - Phone:973-777-4141
Practice Address - Fax:973-777-4242
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00430000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6013503Medicaid
NJ588442Medicare PIN
NJ6013503Medicaid