1003848367 NPI number — DR. ALLAN H. WESTREICH PH.D.

Table of content: DR. ALLAN H. WESTREICH PH.D. (NPI 1003848367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003848367 NPI number — DR. ALLAN H. WESTREICH PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WESTREICH
Provider First Name:
ALLAN
Provider Middle Name:
H.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003848367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
22 DANIEL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILLSBOROUGH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08844-3012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-526-8760
Provider Business Mailing Address Fax Number:
908-842-0389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 STATE ROUTE 28
Provider Second Line Business Practice Location Address:
SUITE 206
Provider Business Practice Location Address City Name:
BRIDGEWATER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08807-1979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-526-8760
Provider Business Practice Location Address Fax Number:
908-842-0389
Provider Enumeration Date:
07/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  35SI00337300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7063601 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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