Provider Demographics
NPI:1649165234
Name:DOWDELL, ALISA LON
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:LON
Last Name:DOWDELL
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 1:215 WYOMING ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2928
Mailing Address - Country:US
Mailing Address - Phone:315-220-5495
Mailing Address - Fax:315-220-5495
Practice Address - Street 1:215 WYOMING ST STE 202
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-2928
Practice Address - Country:US
Practice Address - Phone:315-220-5495
Practice Address - Fax:315-220-5495
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist