Provider Demographics
NPI:1558341495
Name:BRUN, ALAN PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:PETER
Last Name:BRUN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-6907
Mailing Address - Country:US
Mailing Address - Phone:908-561-0269
Mailing Address - Fax:908-561-2854
Practice Address - Street 1:190 GREENBROOK RD
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3903
Practice Address - Country:US
Practice Address - Phone:908-561-0269
Practice Address - Fax:908-561-2854
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ022831207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2873702Medicaid
NJD00317300OtherCDS
NJD00317300OtherCDS
NJC53665Medicare UPIN