Healthcare Provider Details

I. General information

NPI: 1932127719
Provider Name (Legal Business Name): ALISON R PETRASKE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 01/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 PLAINSBORO RD SUITE 500
PLAINSBORO NJ
08536
US

IV. Provider business mailing address

5 PLAINSBORO RD SUITE 500
PLAINSBORO NJ
08536
US

V. Phone/Fax

Practice location:
  • Phone: 609-936-0700
  • Fax: 609-936-0750
Mailing address:
  • Phone: 609-936-0700
  • Fax: 609-936-0750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMA065637
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: