Individual
ALISA FERNANDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
(732) 745-8600
Mailing address
254 EASTON AVE, NEW BRUNSWICK, NJ 08901-1766
(732) 745-8600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL05263500
NJ
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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