Provider Demographics
NPI:1134270903
Name:POET, ALBERT (MD)
Entity type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:POET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA30400207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJPO75322Medicare ID - Type Unspecified
NJC52791Medicare UPIN