Provider Demographics
NPI:1447011010
Name:TOWNSEND, ALYSSA C (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:C
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 GOFFLE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-2014
Mailing Address - Country:US
Mailing Address - Phone:973-636-9000
Mailing Address - Fax:
Practice Address - Street 1:1114 GOFFLE RD STE 104
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-2014
Practice Address - Country:US
Practice Address - Phone:973-636-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-19
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00833900207Q00000X
NJ363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine