Provider Demographics
NPI:1053203315
Name:PRUDENTE, ALISON ELIZABETH (NP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:ELIZABETH
Last Name:PRUDENTE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 W LODGES LN
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2646
Mailing Address - Country:US
Mailing Address - Phone:610-724-7033
Mailing Address - Fax:
Practice Address - Street 1:123 EGG HARBOR RD STE 703
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9410
Practice Address - Country:US
Practice Address - Phone:856-556-0860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-19
Last Update Date:2025-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15369000363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health