Provider Demographics
NPI:1144621962
Name:CUMMINGS, ALEXANDRA JOAN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:JOAN
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:ALEXANDRA
Other - Middle Name:CUMMINGS
Other - Last Name:ONISK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:512 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4803
Mailing Address - Country:US
Mailing Address - Phone:856-797-9161
Mailing Address - Fax:856-797-3637
Practice Address - Street 1:535 SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702
Practice Address - Country:US
Practice Address - Phone:908-355-8877
Practice Address - Fax:908-355-0017
Is Sole Proprietor?:No
Enumeration Date:2014-09-11
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00346100363AM0700X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical