Provider Demographics
NPI:1619979317
Name:FELSEN, ALAN K (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:K
Last Name:FELSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:718 TEANECK ROAD
Mailing Address - Street 2:EXCELCARE MEDICAL ASSOCIATES, PA
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-0000
Mailing Address - Country:US
Mailing Address - Phone:201-833-3000
Mailing Address - Fax:201-227-6207
Practice Address - Street 1:15 ANDERSON STREET
Practice Address - Street 2:EXCELCARE MEDICAL ASSOCIATES, PA
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-0000
Practice Address - Country:US
Practice Address - Phone:201-487-3355
Practice Address - Fax:201-487-0960
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2012-01-26
Deactivation Date:2006-03-22
Deactivation Code:
Reactivation Date:2006-04-11
Provider Licenses
StateLicense IDTaxonomies
NJMA033270000207R00000X
NJ25MA03327000207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC53745Medicare UPIN
C53745Medicare UPIN