Provider Demographics
NPI:1568728491
Name:NASH, ALYSSA COHEN (MD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:COHEN
Last Name:NASH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:MICHELLE
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 S UNION BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3146
Mailing Address - Country:US
Mailing Address - Phone:719-633-5515
Mailing Address - Fax:
Practice Address - Street 1:175 S UNION BLVD STE 350
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3146
Practice Address - Country:US
Practice Address - Phone:719-633-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0055405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841304978OtherTAX ID