Individual
ALYSHA THEOSMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2103 BURLINGTON MOUNT HOLLY RD, BURLINGTON, NJ 08016-4157
(609) 747-9200
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA055669
PA
363AM0700X
Medical Physician Assistant
25MP00298200
NJ
363AS0400X
Surgical Physician Assistant
Primary
25MP00298200
NJ
Other
Enumeration date
09/25/2012
Last updated
10/19/2020
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