Provider Demographics
NPI:1245996222
Name:DESENA, ALYSSA (ND)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:DESENA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 E SALTAIRE RD
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6829
Mailing Address - Country:US
Mailing Address - Phone:860-681-6959
Mailing Address - Fax:
Practice Address - Street 1:46 E SALTAIRE RD
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6829
Practice Address - Country:US
Practice Address - Phone:860-681-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000700175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath