Provider Demographics
NPI:1477377547
Name:BRUAL, ALISSA JOYCE (PA-C)
Entity type:Individual
Prefix:MS
First Name:ALISSA JOYCE
Middle Name:
Last Name:BRUAL
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:360 US HIGHWAY 1 BYP UNIT 102
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7105
Mailing Address - Country:US
Mailing Address - Phone:603-410-6700
Mailing Address - Fax:603-319-8308
Practice Address - Street 1:181 CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-2922
Practice Address - Country:US
Practice Address - Phone:781-730-0045
Practice Address - Fax:781-552-4842
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MAPA101265363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant