Provider Demographics
NPI:1053565630
Name:IOFIN, ALEXANDER (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:IOFIN
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 1:2517 HIGHWAY 35
Mailing Address - Street 2:BLDG H SUITE 201 VALLEY PARK PROFESSIONAL CENTER
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1918
Mailing Address - Country:US
Mailing Address - Phone:732-528-3232
Mailing Address - Fax:732-528-5495
Practice Address - Street 1:2517 HIGHWAY 35
Practice Address - Street 2:BLDG H SUITE 201 VALLEY PARK PROFESSIONAL CENTER
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1918
Practice Address - Country:US
Practice Address - Phone:732-528-3232
Practice Address - Fax:732-528-5495
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0664772084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8081409Medicaid
NJ25MA06647700OtherNJ LICENSE
NJ25MA06647700OtherNJ LICENSE