Provider Demographics
NPI:1902689383
Name:ASSALE, PRISCILLIA ANGIE (NP)
Entity Type:Individual
Prefix:
First Name:PRISCILLIA
Middle Name:ANGIE
Last Name:ASSALE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 QUAKER WAY
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3726
Mailing Address - Country:US
Mailing Address - Phone:973-868-7795
Mailing Address - Fax:
Practice Address - Street 1:1810 QUAKER WAY
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3726
Practice Address - Country:US
Practice Address - Phone:973-868-7795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14891500363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care