| Alyssa Davis Inc. | |
|
39 Lori Way Hauppauge NY 11788-4301 | |
| (917) 842-6189 | |
| Not Available |
| Full Name | Alyssa Davis Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 39 Lori Way, Hauppauge, New York |
| Authorized Official Name and Position | Bradley Feig (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6467413748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alyssa Davis Inc. 39 Lori Way Hauppauge NY 11788-4301 Ph: (917) 842-6189 | Alyssa Davis Inc. 39 Lori Way Hauppauge NY 11788-4301 Ph: (917) 842-6189 |
| NPI Number | 1376946426 |
|---|---|
| Provider Enumeration Date | 10/03/2014 |
| Last Update Date | 10/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376946426 | NPI | - | NPPES |
| D | Other | NY | AUTISM PROVIDER |
| 10300000 | Other | NY | HEALTH CARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 10300000 (New York) | Primary |
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