Provider Demographics
NPI:1689285504
Name:VAZQUEZ, ALEXANDRIA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:
Last Name:VAZQUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 KING GEORGE LN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-3375
Mailing Address - Country:US
Mailing Address - Phone:732-779-0843
Mailing Address - Fax:
Practice Address - Street 1:226 ROUTE 37 W STE 6
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8047
Practice Address - Country:US
Practice Address - Phone:732-348-5798
Practice Address - Fax:732-930-2828
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01044400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily