Basic Information
| Provider Information | |||||||||
| NPI: | 1861924565 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNCKEN | ||||||||
| FirstName: | ALYSSA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 REXLAND DR | ||||||||
| Address2: | |||||||||
| City: | BOONTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070052423 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 CHANGEBRIDGE RD BLDG C3 | ||||||||
| Address2: | |||||||||
| City: | MONTVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070459112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735755540 | ||||||||
| FaxNumber: | 9735754885 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2017 | ||||||||
| LastUpdateDate: | 11/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA10930000 | NJ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.