Basic Information
| Provider Information | |||||||||
| NPI: | 1003865601 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REMDE | ||||||||
| FirstName: | ALAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 755 MEMORIAL PKWY STE 300 | ||||||||
| Address2: | |||||||||
| City: | PHILLIPSBURG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088652748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084546303 | ||||||||
| FaxNumber: | 8662816023 | ||||||||
| Practice Location | |||||||||
| Address1: | 755 MEMORIAL PKWY STE 300 | ||||||||
| Address2: | |||||||||
| City: | PHILLIPSBURG | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08865 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9084546303 | ||||||||
| FaxNumber: | 8662816023 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2006 | ||||||||
| LastUpdateDate: | 06/22/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QS0010X | MA48359 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207QS0010X | 275333-1 | NY | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207Q00000X | 275333-1 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MA48359 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 5635101 | 05 | NJ | MEDICAID |