Provider Demographics
NPI:1922056258
Name:SASTRY, ALISON MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISON
Middle Name:MARY
Last Name:SASTRY
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:1020 INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-5500
Mailing Address - Country:US
Mailing Address - Phone:757-363-9353
Mailing Address - Fax:757-363-0562
Practice Address - Street 1:1020 INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-5500
Practice Address - Country:US
Practice Address - Phone:757-363-9353
Practice Address - Fax:757-363-0562
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012417772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
348116OtherMHNET
0-534-1870OtherECFMG
1582029OtherHIGHMARK
1582029OtherHIGHMARK