Basic Information
| Provider Information | |||||||||
| NPI: | 1942208046 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALESSI | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 457 HADDONFIELD RD | ||||||||
| Address2: | SUITE D1 | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080022220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564064091 | ||||||||
| FaxNumber: | 8564064570 | ||||||||
| Practice Location | |||||||||
| Address1: | 457 HADDONFIELD ROAD | ||||||||
| Address2: | SUITE D1 | ||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8564064091 | ||||||||
| FaxNumber: | 8564064570 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2005 | ||||||||
| LastUpdateDate: | 02/25/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 25MB03567400 | NJ | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | LT-2676 | NH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | T-0332 | NH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 14054 | NH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 30226389 | 05 | NH | MEDICAID | 1519107 | 05 | NJ | MEDICAID |