Provider Demographics
NPI:1225547623
Name:TERRANOVA, ALYSON (PT)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:TERRANOVA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 BERLIN CROSS KEYS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4367
Mailing Address - Country:US
Mailing Address - Phone:856-740-0009
Mailing Address - Fax:856-262-0469
Practice Address - Street 1:542 BERLIN CROSS KEYS RD STE 1
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-4367
Practice Address - Country:US
Practice Address - Phone:856-740-0009
Practice Address - Fax:856-262-0469
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01754300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist