Provider Demographics
NPI:1679581466
Name:ALESSI, TINA M (CNM)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:ALESSI
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:142 VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927-2024
Mailing Address - Country:US
Mailing Address - Phone:973-683-1400
Mailing Address - Fax:
Practice Address - Street 1:111 MADISON AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6097
Practice Address - Country:US
Practice Address - Phone:973-683-1400
Practice Address - Fax:973-683-0700
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25ME00016701367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ66705Medicare UPIN
NJ099711U4NMedicare ID - Type Unspecified