Provider Demographics
NPI:1225882020
Name:CLIFFORD, ALYSSA MARIE
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:CLIFFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 COLONIAL ST
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-2104
Mailing Address - Country:US
Mailing Address - Phone:860-417-7078
Mailing Address - Fax:
Practice Address - Street 1:811 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-3930
Practice Address - Country:US
Practice Address - Phone:860-496-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program