Provider Demographics
NPI:1528040011
Name:DEUTSCH, ALAN D (DO)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:DEUTSCH
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 1:1944 CORLIES AVE.
Mailing Address - Street 2:STE 206
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:732-774-8282
Mailing Address - Fax:732-774-6816
Practice Address - Street 1:1944 CORLIES AVE.
Practice Address - Street 2:STE 206
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753
Practice Address - Country:US
Practice Address - Phone:732-774-8282
Practice Address - Fax:732-774-6816
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB519262084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5614601Medicaid
NJ6472605Medicaid
NJ532538Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NJ6472605Medicaid
NJF51741Medicare UPIN
NJ734253Medicare ID - Type Unspecified