Provider Demographics
NPI:1457115347
Name:DAGROSA, ALYSIA J (BCPA, CFSD, CLC)
Entity Type:Individual
Prefix:MS
First Name:ALYSIA
Middle Name:J
Last Name:DAGROSA
Suffix:
Gender:F
Credentials:BCPA, CFSD, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 PARK PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4002
Mailing Address - Country:US
Mailing Address - Phone:718-283-4757
Mailing Address - Fax:
Practice Address - Street 1:402 PARK PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4002
Practice Address - Country:US
Practice Address - Phone:718-283-4757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN