Provider Demographics
NPI:1538056817
Name:CIANNILLI, ANALISE B (PA-C)
Entity type:Individual
Prefix:
First Name:ANALISE
Middle Name:B
Last Name:CIANNILLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 OCEAN HEIGHTS AVE APT L11
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-7211
Mailing Address - Country:US
Mailing Address - Phone:609-214-3928
Mailing Address - Fax:
Practice Address - Street 1:401 OCEAN HEIGHTS AVE APT L11
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-7211
Practice Address - Country:US
Practice Address - Phone:609-214-3928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant