Provider Demographics
NPI:1124717103
Name:ALENA DEBROSSE APN LLC
Entity type:Organization
Organization Name:ALENA DEBROSSE APN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALENA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DEBROSSE
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:516-312-9486
Mailing Address - Street 1:801A POMPTON RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-7261
Mailing Address - Country:US
Mailing Address - Phone:516-312-9486
Mailing Address - Fax:
Practice Address - Street 1:801A POMPTON RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-7261
Practice Address - Country:US
Practice Address - Phone:516-312-9486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty