Provider Demographics
NPI:1255445599
Name:VOGEL, ALYSON ROSE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALYSON
Middle Name:ROSE
Last Name:VOGEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ALYSON
Other - Middle Name:ROSE
Other - Last Name:FECCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:240 MARYLAND ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1733
Mailing Address - Country:US
Mailing Address - Phone:917-940-8420
Mailing Address - Fax:
Practice Address - Street 1:240 MARYLAND ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1733
Practice Address - Country:US
Practice Address - Phone:917-940-8420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT23.004995363A00000X
MDC0008168363A00000X
IL085.008242363A00000X
NJ25MP00173100363A00000X
MAPA8027363A00000X
PAMA062958363A00000X
NY011307363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant