Provider Demographics
NPI:1598799108
Name:ACKLEY, ALEXANDER M (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:M
Last Name:ACKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3626 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5922
Mailing Address - Country:US
Mailing Address - Phone:609-243-0445
Mailing Address - Fax:609-452-7577
Practice Address - Street 1:253 WITHERSPOON ST FL 2
Practice Address - Street 2:LAMBERT HOUSE, MEDICAL CTR AT PRINCETON
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3211
Practice Address - Country:US
Practice Address - Phone:609-497-4301
Practice Address - Fax:609-497-4992
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03178800207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJA40929Medicare UPIN
NJ192207MW3Medicare ID - Type Unspecified