Provider Demographics
NPI:1700803350
Name:MCALISTER, LAUREN JOY (ATC)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:JOY
Last Name:MCALISTER
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 WESTCHESTER CT
Mailing Address - Street 2:UNIT # 2
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8756
Mailing Address - Country:US
Mailing Address - Phone:609-385-5025
Mailing Address - Fax:
Practice Address - Street 1:401 MONROE AVE
Practice Address - Street 2:
Practice Address - City:KENILWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07033-1220
Practice Address - Country:US
Practice Address - Phone:908-931-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT001302002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer