Provider Demographics
NPI:1902868698
Name:ROSENHECK, ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:
Last Name:ROSENHECK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 ROUTE 9 S
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-3333
Mailing Address - Country:US
Mailing Address - Phone:732-780-0088
Mailing Address - Fax:732-780-0374
Practice Address - Street 1:2220 ROUTE 9 S
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-3333
Practice Address - Country:US
Practice Address - Phone:732-780-0088
Practice Address - Fax:732-780-0374
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00468700152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ144754OtherCOLE/ EYE MED
NJ28499OtherAETNA
NJT77805Medicare UPIN
NJ144754OtherCOLE/ EYE MED