Provider Demographics
NPI:1174091441
Name:YOUNGMAN, ALYSSA CLAIRE (APN)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:CLAIRE
Last Name:YOUNGMAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-2635
Mailing Address - Country:US
Mailing Address - Phone:215-359-7883
Mailing Address - Fax:
Practice Address - Street 1:19 E MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-1503
Practice Address - Country:US
Practice Address - Phone:973-543-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00868300363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health