Healthcare Provider Details

I. General information

NPI: 1386828101
Provider Name (Legal Business Name): EDISON S ALEJANDRINO RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PARSONAGE RD SUITE 500
EDISON NJ
08837-2429
US

IV. Provider business mailing address

10 PARSONAGE RD SUITE 500
EDISON NJ
08837-2429
US

V. Phone/Fax

Practice location:
  • Phone: 732-494-6226
  • Fax: 732-494-8762
Mailing address:
  • Phone: 732-494-6226
  • Fax: 732-494-8762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NO10133800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: