Individual
DR. ALAN KEITH TANNENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10 PLUM STREET, UNIVERSITY RADIOLOGY AT ROBERT WOOD JOHNSON LLC, NEW BRUNSWICK, NJ 08901
(732) 249-4410
(732) 249-1208
Mailing address
18 CENTRE DRIVE, SUITE 205, MONROE TOWNSHIP, NJ 08831-3260
(609) 395-7600
(609) 395-7559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MA048977
NJ
207R00000X
Internal Medicine Physician
25MA04897700
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
25MA04897700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060015491
RR MEDICARE PTAN
NJ
05
—
0626708
—
NJ
01
—
1092802
HORIZON NJ HEALTH
NJ
01
—
15634
UNIVERSITY HEALTH PLANS
NJ
01
—
18141
AMERIGROUP
NJ
01
—
29269
BEECH STREET
NJ
01
—
F04685
HEALTHNET
NJ
01
—
M10000542 01
AMERICHOICE
NJ
Enumeration date
10/23/2006
Last updated
04/08/2010
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