Provider Demographics
NPI:1003546078
Name:FARINA, ALYSSA LEE (MD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LEE
Last Name:FARINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E 121ST ST APT 8A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3057
Mailing Address - Country:US
Mailing Address - Phone:386-960-3921
Mailing Address - Fax:
Practice Address - Street 1:1650 GRAND CONCOURSE APT 2A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7697
Practice Address - Country:US
Practice Address - Phone:386-960-3921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program