Individual
ALLISON DERTOUZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2999 PRINCETON PIKE STE 2, LAWRENCEVILLE, NJ 08648-3261
(609) 403-8840
Mailing address
2999 PRINCETON PIKE STE 2, LAWRENCEVILLE, NJ 08648-3261
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00746500
NJ
363A00000X
Physician Assistant
C5-0012277
DE
Other
Enumeration date
08/02/2021
Last updated
08/07/2025
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