Provider Demographics
NPI:1770040719
Name:BELCASTRO, ALYSSA FRANCESCA
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:FRANCESCA
Last Name:BELCASTRO
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 1:117 NORWALK AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5658
Mailing Address - Country:US
Mailing Address - Phone:917-902-7829
Mailing Address - Fax:
Practice Address - Street 1:117 NORWALK AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5658
Practice Address - Country:US
Practice Address - Phone:917-902-7829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-42657103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst