Provider Demographics
NPI:1760901763
Name:ALIBRANDO, KAITLYN (PA)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:ALIBRANDO
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0346
Practice Address - Street 1:100 BOWMAN DR FL 1
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-247-2594
Practice Address - Fax:856-247-2597
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MP00445600363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant