Provider Demographics
NPI:1760042782
Name:HAVLIK, ALEXANDRA JO (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:JO
Last Name:HAVLIK
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1026 BROAD ST UNIT 18
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4380
Mailing Address - Country:US
Mailing Address - Phone:732-542-0002
Mailing Address - Fax:
Practice Address - Street 1:1026 BROAD ST UNIT 18
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4380
Practice Address - Country:US
Practice Address - Phone:732-542-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical