Provider Demographics
NPI:1639241086
Name:ADVANCE PSYCHIATRIC CARE PA
Entity Type:Organization
Organization Name:ADVANCE PSYCHIATRIC CARE PA
Other - Org Name:ALEXANDER IOFIN MD
Other - Org Type:Other Name
Authorized Official - Title/Position:MD PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:IOFIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-528-3232
Mailing Address - Street 1:2517 HIGHWAY 35
Mailing Address - Street 2:BLDG H SUITE 201 VALLEY PARK PROFESSIONAL CENTER
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1918
Mailing Address - Country:US
Mailing Address - Phone:732-528-3232
Mailing Address - Fax:732-528-5495
Practice Address - Street 1:2517 HIGHWAY 35
Practice Address - Street 2:BLDG H SUITE 201 VALLEY PARK PROFESSIONAL CENTER
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1918
Practice Address - Country:US
Practice Address - Phone:732-528-3232
Practice Address - Fax:732-528-5495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0664772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8081409Medicaid
NJ25MA066477OtherMEDICAL LICENSE
NJ025649Medicare PIN
G89430Medicare UPIN
NJ8081409Medicaid