Provider Demographics
NPI:1982758322
Name:ALEXANDER PETCU MD LLC
Entity Type:Organization
Organization Name:ALEXANDER PETCU MD LLC
Other - Org Name:VILLAGE MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:PETCU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-761-1788
Mailing Address - Street 1:1 DAG HAMMARSKJOLD BLVD
Mailing Address - Street 2:STE 3
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-5221
Mailing Address - Country:US
Mailing Address - Phone:732-761-1788
Mailing Address - Fax:732-761-1323
Practice Address - Street 1:1 DAG HAMMARSKJOLD BLVD
Practice Address - Street 2:STE 3
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-5221
Practice Address - Country:US
Practice Address - Phone:732-761-1788
Practice Address - Fax:732-761-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty