Provider Demographics
NPI:1841478187
Name:BYFIELD, ILYASAH (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ILYASAH
Middle Name:
Last Name:BYFIELD
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RYAN RD
Mailing Address - Street 2:MINUTE CLINIC
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-2445
Mailing Address - Country:US
Mailing Address - Phone:347-739-0230
Mailing Address - Fax:
Practice Address - Street 1:4 RYAN RD
Practice Address - Street 2:MINUTE CLINIC
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-2445
Practice Address - Country:US
Practice Address - Phone:347-739-0230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00135300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ131246XVAMedicare UPIN