Provider Demographics
NPI:1689675068
Name:HERBST, ALLISON BETH (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:BETH
Last Name:HERBST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1015 BRIGGS RD STE 200
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4114
Practice Address - Country:US
Practice Address - Phone:856-727-0900
Practice Address - Fax:856-231-8428
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08223400207RE0101X
PAMD055503L207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ112034CSFMedicare PIN
G47298Medicare UPIN