Provider Demographics
NPI:1023187143
Name:BECKER, ALYSSA GELMANN (MD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:GELMANN
Last Name:BECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 EAST ALLENDALE ROAD
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458
Mailing Address - Country:US
Mailing Address - Phone:201-825-3933
Mailing Address - Fax:
Practice Address - Street 1:82 EAST ALLENDALE ROAD
Practice Address - Street 2:SUITE 3A
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458
Practice Address - Country:US
Practice Address - Phone:201-825-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA071672207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ448237Medicare UPIN