Basic Information
| Provider Information | |||||||||
| NPI: | 1740620343 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SISSON | ||||||||
| FirstName: | COLLEEN | ||||||||
| MiddleName: | MURPHY | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21 KINGSBERRY DR | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088734302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7323223689 | ||||||||
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| Practice Location | |||||||||
| Address1: | 90 WASHINGTON VALLEY RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | BEDMINSTER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079212118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8773455300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2013 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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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 | 363A00000X | 25MP00310000 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.