Provider Demographics
NPI:1427679851
Name:BROWN, ALEXANDRIA (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ALEXANDRIA
Other - Middle Name:DANAE
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:515 VALLEY ST STE 203
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-4300
Mailing Address - Country:US
Mailing Address - Phone:908-663-2929
Mailing Address - Fax:
Practice Address - Street 1:515 VALLEY ST STE 203
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-4300
Practice Address - Country:US
Practice Address - Phone:908-663-2929
Practice Address - Fax:908-219-6213
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant