Individual
ALAN MERRILL DIETZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19 DAVIS AVE FL 4, NEPTUNE, NJ 07753-4488
(732) 212-6598
(732) 922-2026
Mailing address
331 NEWMAN SPRINGS RD STE 220, RED BANK, NJ 07701-5792
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
038845
CT
2086S0129X
Vascular Surgery Physician
Primary
25MA09413600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038845
CONNECTICARE
CT
01
—
0V7532
HEALTH NET
CT
05
—
1388455
—
CT
01
—
2372975
AETNA US HEALTHCARE
CT
01
—
810160110
PHCS
CT
01
—
830396
UNITED HEALTHCARE
CT
01
—
8897122
CIGNA
CT
01
—
AS1058
OXFORD
CT
01
—
P00230453
RAILROAD MEDICARE
CT
Enumeration date
06/09/2006
Last updated
06/16/2025
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