Provider Demographics
NPI:1558142992
Name:BERNASCO, ALISON (LAC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:BERNASCO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 ENGLISH PL
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2741
Mailing Address - Country:US
Mailing Address - Phone:201-452-0724
Mailing Address - Fax:
Practice Address - Street 1:14 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920
Practice Address - Country:US
Practice Address - Phone:908-719-1362
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00144600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist