Basic Information
| Provider Information | |||||||||
| NPI: | 1679581466 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALESSI | ||||||||
| FirstName: | TINA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 142 VISTA DR | ||||||||
| Address2: | |||||||||
| City: | CEDAR KNOLLS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079272024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736831400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 MADISON AVE | ||||||||
| Address2: | SUITE 305 | ||||||||
| City: | MORRISTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079606097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736831400 | ||||||||
| FaxNumber: | 9736830700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | 25ME00016701 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.