Provider Demographics
NPI:1033231493
Name:ALAN J LIFTIN, MD, MEDICAL SERVICES, PC
Entity type:Organization
Organization Name:ALAN J LIFTIN, MD, MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:LIFTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-535-5800
Mailing Address - Street 1:22 OLD SHORT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5604
Mailing Address - Country:US
Mailing Address - Phone:973-535-9550
Mailing Address - Fax:
Practice Address - Street 1:22 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5604
Practice Address - Country:US
Practice Address - Phone:973-535-9550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ54835207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJE58216Medicare UPIN
NJ141011ZB9EMedicare PIN
NJ141009Medicare PIN