Provider Demographics
NPI:1215270293
Name:SERENELLI, ALYSIA D (PT)
Entity type:Individual
Prefix:
First Name:ALYSIA
Middle Name:D
Last Name:SERENELLI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ALYSIA
Other - Middle Name:D
Other - Last Name:BENITEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 ARENA DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-2426
Mailing Address - Country:US
Mailing Address - Phone:609-585-2333
Mailing Address - Fax:609-585-2333
Practice Address - Street 1:1900 ARENA DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2426
Practice Address - Country:US
Practice Address - Phone:609-585-2333
Practice Address - Fax:609-585-2333
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA1487700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist