Provider Demographics
NPI:1306500517
Name:MARTELL, ALLYSON J (APN)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:J
Last Name:MARTELL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CRANE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-2202
Mailing Address - Country:US
Mailing Address - Phone:973-296-3885
Mailing Address - Fax:
Practice Address - Street 1:250 MOONACHIE RD
Practice Address - Street 2:
Practice Address - City:MOONACHIE
Practice Address - State:NJ
Practice Address - Zip Code:07074-1378
Practice Address - Country:US
Practice Address - Phone:201-596-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01220900363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care