Provider Demographics
NPI:1265430433
Name:ADLER, ARVIN JAY (DO)
Entity type:Individual
Prefix:DR
First Name:ARVIN
Middle Name:JAY
Last Name:ADLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2840
Mailing Address - Country:US
Mailing Address - Phone:973-365-5088
Mailing Address - Fax:973-365-4448
Practice Address - Street 1:350 BOULEVARD
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2840
Practice Address - Country:US
Practice Address - Phone:973-365-5088
Practice Address - Fax:973-365-4448
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1733932085R0001X
NJ25MB065021002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01096446Medicaid
A62347Medicare UPIN
NY34E351Medicare ID - Type Unspecified