Provider Demographics
NPI:1437764545
Name:O'NEILL, ALISON (NP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:O'NEILL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:CLEMENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 OGDEN AVE # 2
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07307-1119
Mailing Address - Country:US
Mailing Address - Phone:917-613-1776
Mailing Address - Fax:
Practice Address - Street 1:720 MONROE ST STE E407
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6356
Practice Address - Country:US
Practice Address - Phone:732-778-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJDCATEMP-02792363LA2200X
NY309650363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health