Provider Demographics
NPI:1629128244
Name:DR. ALEXANDER G. KARPENOS
Entity Type:Organization
Organization Name:DR. ALEXANDER G. KARPENOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-287-0255
Mailing Address - Street 1:4 ETHEL RD STE 405B
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2841
Mailing Address - Country:US
Mailing Address - Phone:732-287-0255
Mailing Address - Fax:732-287-0355
Practice Address - Street 1:4 ETHEL RD STE 405B
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2841
Practice Address - Country:US
Practice Address - Phone:732-287-0255
Practice Address - Fax:732-287-0355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6535208Medicaid
NJE87463Medicare UPIN
NJ6535208Medicaid