Provider Demographics
NPI:1427005768
Name:ZENACK, ALISSA HAYLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:HAYLEY
Last Name:ZENACK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11 BEDFORD PL
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3603
Mailing Address - Country:US
Mailing Address - Phone:201-475-2955
Mailing Address - Fax:201-820-4597
Practice Address - Street 1:899 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-4914
Practice Address - Country:US
Practice Address - Phone:201-820-4600
Practice Address - Fax:201-820-4597
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB 72374208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics