Provider Demographics
NPI:1497311443
Name:D'ALLIESSI, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:D'ALLIESSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEMORIAL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WARETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08758-1762
Mailing Address - Country:US
Mailing Address - Phone:609-607-1900
Mailing Address - Fax:609-607-0682
Practice Address - Street 1:1 MEMORIAL DR STE 102
Practice Address - Street 2:
Practice Address - City:WARETOWN
Practice Address - State:NJ
Practice Address - Zip Code:08758-1762
Practice Address - Country:US
Practice Address - Phone:609-607-1900
Practice Address - Fax:609-607-0682
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0290600251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health