Basic Information
Provider Information
NPI: 1760487938
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZALKOWITZ
FirstName: ALAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 784 FRANKLIN AVE STE 250
Address2:  
City: FRANKLIN LAKES
State: NJ
PostalCode: 074171306
CountryCode: US
TelephoneNumber: 8447770910
FaxNumber: 2015600712
Practice Location
Address1: 784 FRANKLIN AVE STE 250
Address2:  
City: FRANKLIN LAKES
State: NJ
PostalCode: 07417
CountryCode: US
TelephoneNumber: 8447770910
FaxNumber: 2015600712
Other Information
ProviderEnumerationDate: 06/15/2005
LastUpdateDate: 10/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500XMA028880NJY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

ID Information
IDTypeStateIssuerDescription
044600905NJ MEDICAID


Home