MRS. ALISA STEPHANIE GOULBOURNE-SCOTT (NPI# 1942428255) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942428255 |
| Entity Type | Individual |
| Full Name | MRS. ALISA STEPHANIE GOULBOURNE-SCOTT |
| Credential | PA-C |
| Practice Address |
19 Henrietta Ct Ridgewood NJ 07450-2938 |
| Practice Telephone | 2016707498 |
| Mailing Telephone | 2016707498 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2007-09-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0041901 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
19 HENRIETTA CT |
| City | RIDGEWOOD |
| State | NJ |
| Zip Code | 07450-2938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023675857 | Children's Aid and Family Services, Inc. | Behavioral Analyst | 213 Larue Road, W. Milford, NJ 07450 | 2019-05-28 |
| 1962065979 | Corey Chan | Student in an Organized Health Care Education/Training Program | 550 Lynn St, Ridgewood, NJ 07450 | 2019-04-16 |
| 1679058200 | Raymond Hawash | Pharmacist | 223 North Van Dien Ave, Ridgewood, NJ 07450 | 2018-09-28 |
| 1548771967 | Leonard Swerdlof | Dentist | 160 S Broad St, Ridgewood, NJ 07450 | 2017-10-12 |
| 1336671114 | Camp Sunshine and Camp Snowflake, Inc. | Respite Care | 1133 East Ridgewood Avenue, Ridgewood, NJ 07450 | 2017-03-30 |
| 1952764862 | Elysium Aesthetics and Vein Care, Inc | Radiology | 400 State Route 17, Ridgewood, NJ 07450 | 2016-03-30 |
| 1780077362 | Paul Walter Dasher | Psychologist | 76 West Ridgewood Avenue, Ridgewood, NJ 07450 | 2015-03-06 |
| 1255750071 | Myron Frank Lesh | Pharmacist | 305 E. Ridgewood Ave., Ridgewood, NJ 07450 | 2014-04-09 |
| 1649612912 | Jane Worthman-leva | Nutritionist | 357 South Irving St, Ridgewood, NJ 07450 | 2013-07-26 |
| 1427398858 | Life Opportunities Unlimited A Non Profit Corp. | Day Training, Developmentally Disabled Services | 75 North Maple Ave, Suite 104, Ridgewood, NJ 07450 | 2013-02-21 |
| Find all providers in zip 07450 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841767761 | Botros Garas | Physician Assistant | 6061 Putnam Ave, Ridgewood, NY 11385-4529 | 2018-10-29 |
| 1902185424 | Nicole Marie Siegel | Physician Assistant | 7326 70th St, Ridgewood, NY 11385-7118 | 2011-08-15 |
| 1154531960 | Sharon Soroka Ukleja | Physician Assistant | 20 Wilsey Sq Ste C, Ridgewood, NJ 07450-3730 | 2007-05-23 |
| 1285245811 | Jessica I Deleon | Physician Assistant | 85 S Maple Ave, Ridgewood, NJ 07450-4561 | 2020-08-17 |
| 1295360576 | Jill Kathleen Mcgovern | Physician Assistant | 106 Prospect Street, 3rd Floor, Ridgewood, NJ 07450-4433 | 2020-03-07 |
| 1417508391 | Nirali Patel | Physician Assistant | 85 S Maple Ave, Ridgewood, NJ 07450-4561 | 2019-09-23 |
| 1053888362 | Diana S Cronenberg | Physician Assistant | 85 S Maple Ave, Ridgewood, NJ 07450-4561 | 2018-10-25 |
| 1962986703 | Nerricka Nalundasan | Physician Assistant | 85 S Maple Ave, Ridgewood, NJ 07450-4561 | 2018-09-18 |
| 1558857748 | Amanda Ukleja | Physician Assistant | 223 N Van Dien Ave, Ridgewood, NJ 07450-2726 | 2018-07-10 |
| 1083109474 | Sydney Denault | Physician Assistant | 85 S Maple Ave, Ridgewood, NJ 07450-4561 | 2018-06-27 |
| Find all providers in RIDGEWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.