Provider Demographics
NPI:1043434129
Name:ALBERT POET, MD, PA
Entity type:Organization
Organization Name:ALBERT POET, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:POET
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:609-597-6800
Mailing Address - Street 1:703 MILL CREEK RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3828
Mailing Address - Country:US
Mailing Address - Phone:609-597-6800
Mailing Address - Fax:609-597-5282
Practice Address - Street 1:703 MILL CREEK RD
Practice Address - Street 2:SUITE G
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3828
Practice Address - Country:US
Practice Address - Phone:609-597-6800
Practice Address - Fax:609-597-5282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA30400207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherFEDERAL TAX ID
NJPO75322Medicare ID - Type Unspecified
NJ=========OtherFEDERAL TAX ID