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Individual

MARIA ALYSSA FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
MARSHALL HALL SUITE 50 8000 YORK RD, TOWSON, MD 21252-0001
(732) 618-8947
Mailing address
11 EMILY DR, OLD BRIDGE, NJ 08857-3810
(732) 251-6440

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
F65695196161972
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W204230349
AETNA
NJ
Enumeration date
06/28/2017
Last updated
06/28/2017
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