Provider Demographics
NPI:1467428623
Name:DUBIN, ALVIN DANIEL (DO)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:DANIEL
Last Name:DUBIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3449
Mailing Address - Country:US
Mailing Address - Phone:856-795-6432
Mailing Address - Fax:
Practice Address - Street 1:1924 ROUTE 70 E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-2118
Practice Address - Country:US
Practice Address - Phone:856-424-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB01668500207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
E56498Medicare UPIN