Provider Demographics
NPI:1700908332
Name:KAGEL, ALAN S (EDD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:S
Last Name:KAGEL
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 JESSUP RD
Mailing Address - Street 2:SUITE 808
Mailing Address - City:THOROFARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-9354
Mailing Address - Country:US
Mailing Address - Phone:856-845-7800
Mailing Address - Fax:856-845-3861
Practice Address - Street 1:800 JESSUP RD
Practice Address - Street 2:SUITE 808
Practice Address - City:THOROFARE
Practice Address - State:NJ
Practice Address - Zip Code:08086-9354
Practice Address - Country:US
Practice Address - Phone:856-845-7800
Practice Address - Fax:856-845-3861
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2276103TC0700X
PAPS004811L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA617030Medicare ID - Type Unspecified
NJ617028Medicare ID - Type Unspecified