Active NPI
Alfredo Mennonna, PA-C
- Physician Assistant
- Morristown, NJ
National Provider Identifier
1093200370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 25MP00144800
- Practice address
- 100 Madison Ave.
Morristown, NJ 07960 - Phone
- (973) 971-5488
- Fax
- (973) 290-7175
- NPI assigned
- Jun 28, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 25MP00144800 | NJ | Primary |
Addresses
Primary practice location
100 Madison Ave.
Morristown, NJ 07960
Mailing address
104 East Hanover Ave.
Cedar Knolls, NJ 07927
Phone (973) 605-8056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MP00144800 | NJ | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530144000000",
"number": "1093200370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 EAST HANOVER AVE.",
"city": "CEDAR KNOLLS",
"state": "NJ",
"postal_code": "07927",
"telephone_number": "973-605-8056",
"fax_number": "973-605-8045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MADISON AVE.",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "07960",
"telephone_number": "973-971-5488",
"fax_number": "973-290-7175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENNONNA",
"first_name": "ALFREDO",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-28",
"last_updated": "2018-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NJ",
"license": "25MP00144800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morristown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.