Provider Demographics
NPI:1558398396
Name:KUSHNER, ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:KUSHNER
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 1:6103 LANSDOWNE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-3997
Mailing Address - Country:US
Mailing Address - Phone:215-877-6688
Mailing Address - Fax:610-667-0393
Practice Address - Street 1:6103 LANSDOWNE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19151-3997
Practice Address - Country:US
Practice Address - Phone:215-877-6688
Practice Address - Fax:610-667-0393
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2232L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008008190001Medicaid
PA0008008190001Medicaid
T29638Medicare UPIN