Provider Demographics
NPI:1114730314
Name:PRINCE, ALLISON (NP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:PRINCE
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LEWIS RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2605
Mailing Address - Country:US
Mailing Address - Phone:845-492-9691
Mailing Address - Fax:
Practice Address - Street 1:159 E 53RD ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-4602
Practice Address - Country:US
Practice Address - Phone:212-263-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NK15261000363LW0102X
NY421849363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health