MRS. Alisa Stephanie Goulbourne-Scott, PA-C
NPI #1942428255 in Ridgewood, New Jersey
Provider Information
- NPI Number
- 1942428255
- Entity Type
- Individual
- Name
- MRS. Alisa Stephanie Goulbourne-Scott, PA-C
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Apr 23, 2007
- Last Updated
- Sep 14, 2007
Practice Location
- Address
- 19 HENRIETTA CT
- City
- Ridgewood
- State
- New Jersey
- ZIP Code
- 07450-2938
- Phone
- (201) 670-7498
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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