Provider Demographics
NPI:1154410728
Name:MERENA, ALISON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:MERENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 NORTH MAPLE AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HOHOKUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:611 N MAPLE AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1668
Practice Address - Country:US
Practice Address - Phone:201-447-1112
Practice Address - Fax:201-447-1180
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ083038MYEMedicare ID - Type Unspecified