Provider Demographics
NPI:1407995558
Name:BISCHOF, ALYCIA LEIGH (APN,C)
Entity Type:Individual
Prefix:MRS
First Name:ALYCIA
Middle Name:LEIGH
Last Name:BISCHOF
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Gender:F
Credentials:APN,C
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Mailing Address - Street 1:1050 MANTUA PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1141
Mailing Address - Country:US
Mailing Address - Phone:856-853-0848
Mailing Address - Fax:856-853-1889
Practice Address - Street 1:1050 MANTUA PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:WENONAH
Practice Address - State:NJ
Practice Address - Zip Code:08090-1141
Practice Address - Country:US
Practice Address - Phone:856-853-0848
Practice Address - Fax:856-853-1889
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2013-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NN09845700363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics