Provider Demographics
NPI:1780697698
Name:HASELKORN, ALEXANDER (M D)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:HASELKORN
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 BROADWAY
Mailing Address - Street 2:SUITE D
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1353
Mailing Address - Country:US
Mailing Address - Phone:973-279-8850
Mailing Address - Fax:973-279-9716
Practice Address - Street 1:750 BROADWAY
Practice Address - Street 2:SUITE D
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1353
Practice Address - Country:US
Practice Address - Phone:973-279-8850
Practice Address - Fax:973-279-9716
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA021752002086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD59953OtherAMERIHEALTH
NJ12124OtherUNIVERSITY HEALTH PLAN
NJ1042506OtherHORIZON NJ HEALTH
NJP2564958OtherOXFORD
NJOK7331OtherHEALTH NET
NJ10590OtherAMERIGROUP
NJ4093613OtherAETNA
NJ63409OtherWELL CHOICE
NJ01000062500OtherAMERICHOICE
NJ2911205Medicaid
NJ63409OtherWELL CHOICE
NJ2911205Medicaid