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General NPI Number Information
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NPI Number | 1316303720
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Entity Type | Individual
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Provider Name | ALICIA MARIE ANDALORO PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/14/2016
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 200 S ORANGE AVE STE 295
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 201-449-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S ORANGE AVE STE 295
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 201-449-1000
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA058061
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0007603
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00388800
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License Number State | NJ
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