Provider Demographics
NPI:1801446265
Name:BLAZEJEWSKI, ALLYSON ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:ELIZABETH
Last Name:BLAZEJEWSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 CHESTER RIDGE DR APT H
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-8538
Mailing Address - Country:US
Mailing Address - Phone:908-235-6922
Mailing Address - Fax:
Practice Address - Street 1:306 WESTWOOD AVE STE 401
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4342
Practice Address - Country:US
Practice Address - Phone:336-885-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-18
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-09441207RC0000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease