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General NPI Number Information
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NPI Number | 1043707276
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Entity Type | Individual
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Provider Name | ALYSSA MARTIN PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1374 WHITEHORSE HAMILTON SQUARE RD FL 2
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City | TRENTON
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State | NJ
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Zip | 08690-3701
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Country | US
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Telephone | 609-586-1319
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Fax |
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Provider Business Mailing Address
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Address Line | 1374 WHITEHORSE HAMILTON SQUARE RD FL 2
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City | TRENTON
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State | NJ
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Zip | 08690-3701
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Country | US
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Telephone | 609-586-1319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C110000025
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA059701
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 25MP00504000
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | OA004442
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License Number State | PA
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