Provider Demographics
NPI:1003090275
Name:ZASLAVSKY, ALEXANDR (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDR
Middle Name:
Last Name:ZASLAVSKY
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:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-0111
Mailing Address - Country:US
Mailing Address - Phone:856-315-4680
Mailing Address - Fax:
Practice Address - Street 1:5 GREENTREE CENTER
Practice Address - Street 2:SUITE 117
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-315-4680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253888207R00000X
MDD0075345207R00000X
NJ25MA09608800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ414828ZPCNMedicare PIN
MD279755YVZMedicare PIN
MD350732YWVZMedicare PIN
MD279755ZDDBMedicare PIN