Healthcare Provider Details

I. General information

NPI: 1548774854
Provider Name (Legal Business Name): DEBRA LOUISE ALFANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 11/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 CENTENNIAL AVE
PISCATAWAY NJ
08854-3907
US

IV. Provider business mailing address

151 CENTENNIAL AVE
PISCATAWAY NJ
08854-3907
US

V. Phone/Fax

Practice location:
  • Phone: 732-235-5000
  • Fax: 732-235-7221
Mailing address:
  • Phone: 732-235-5000
  • Fax: 732-235-7221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: