Provider Demographics
NPI:1942208046
Name:ALESSI, PAUL J (DO)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:ALESSI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 HADDONFIELD RD
Mailing Address - Street 2:SUITE D1
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2220
Mailing Address - Country:US
Mailing Address - Phone:856-406-4091
Mailing Address - Fax:856-406-4570
Practice Address - Street 1:457 HADDONFIELD ROAD
Practice Address - Street 2:SUITE D1
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002
Practice Address - Country:US
Practice Address - Phone:856-406-4091
Practice Address - Fax:856-406-4570
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB03567400207R00000X
NHLT-2676207R00000X
NHT-0332207R00000X
NH14054207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30226389Medicaid
NJ1519107Medicaid
NJ1519107Medicaid
NJ458480A0BMedicare PIN
C58619Medicare UPIN