Provider Demographics
NPI:1568436996
Name:KRASINSKAS, ALYSSA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:M
Last Name:KRASINSKAS
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 1:1364 CLIFTON RD NE RM H178
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-2546
Mailing Address - Country:US
Mailing Address - Phone:404-712-4178
Mailing Address - Fax:
Practice Address - Street 1:1364 CLIFTON RD NE RM H178
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-2546
Practice Address - Country:US
Practice Address - Phone:404-712-4178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70172207ZP0102X
PAMD063580L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001886845Medicaid
PAH55893Medicare UPIN