Provider Demographics
NPI:1578670253
Name:GINGOLD, ALAN R (DO)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:GINGOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 COURTYARD DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-4255
Mailing Address - Country:US
Mailing Address - Phone:908-218-9222
Mailing Address - Fax:908-218-9818
Practice Address - Street 1:511 COURTYARD DR
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4255
Practice Address - Country:US
Practice Address - Phone:908-218-9222
Practice Address - Fax:908-218-9818
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08037900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist