Provider Demographics
NPI:1841747391
Name:D'ALESSANDRO, M JANE (NP-C)
Entity Type:Individual
Prefix:
First Name:M
Middle Name:JANE
Last Name:D'ALESSANDRO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3296
Mailing Address - Country:US
Mailing Address - Phone:866-306-2026
Mailing Address - Fax:833-228-5591
Practice Address - Street 1:11 GALLAGHER DRIVE
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-1146
Practice Address - Country:US
Practice Address - Phone:570-970-1030
Practice Address - Fax:570-970-0511
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232981526Medicaid
PA232981526Medicaid
PA232981526Medicare Oscar/Certification
PA232981526Medicare PIN