Provider Demographics
NPI:1255367587
Name:JIMENEZ, ALINA (PA)
Entity type:Individual
Prefix:MRS
First Name:ALINA
Middle Name:
Last Name:JIMENEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MRS
Other - First Name:ALINA
Other - Middle Name:
Other - Last Name:GONZALEZ MELIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:278 RECTOR ST
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-4435
Mailing Address - Country:US
Mailing Address - Phone:732-826-1023
Mailing Address - Fax:
Practice Address - Street 1:86 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-2242
Practice Address - Country:US
Practice Address - Phone:732-826-1881
Practice Address - Fax:732-826-1108
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00133500363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical