Provider Demographics
NPI:1063275436
Name:ALFONSO BARON, NICOLAS ALEJANDRO (PA)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:ALEJANDRO
Last Name:ALFONSO BARON
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:600 ROOSEVELT BLVD APT 314
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-3133
Mailing Address - Country:US
Mailing Address - Phone:703-402-4711
Mailing Address - Fax:
Practice Address - Street 1:100 E CARROLL ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5422
Practice Address - Country:US
Practice Address - Phone:410-546-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant