Provider Demographics
NPI:1598392565
Name:FIERSTEIN, ALEX SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:SCOTT
Last Name:FIERSTEIN
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 1:826 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2321
Mailing Address - Country:US
Mailing Address - Phone:215-855-1054
Mailing Address - Fax:215-855-3786
Practice Address - Street 1:826 N BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2321
Practice Address - Country:US
Practice Address - Phone:215-855-1054
Practice Address - Fax:215-855-3786
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS022841207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program