Provider Demographics
NPI:1497093009
Name:BREWER, ANGELICA J (PA)
Entity Type:Individual
Prefix:MS
First Name:ANGELICA
Middle Name:J
Last Name:BREWER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1300 N HOLOPONO ST STE 215
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-6945
Mailing Address - Country:US
Mailing Address - Phone:808-874-3444
Mailing Address - Fax:808-874-3443
Practice Address - Street 1:3548 ROUTE 9
Practice Address - Street 2:SUITE 2
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-2765
Practice Address - Country:US
Practice Address - Phone:732-679-6738
Practice Address - Fax:732-679-9566
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2021-02-08
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00300800363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical