Provider Demographics
NPI:1316640170
Name:GIRARD, ALISA ODILE (MD)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:ODILE
Last Name:GIRARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ROEBLING
Mailing Address - State:NJ
Mailing Address - Zip Code:08554-1006
Mailing Address - Country:US
Mailing Address - Phone:732-710-0742
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:732-710-0742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program