Provider Demographics
NPI:1700236007
Name:JANN, ALYSSA (OD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:JANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MACINTOSH RD
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-2070
Mailing Address - Country:US
Mailing Address - Phone:978-828-1729
Mailing Address - Fax:
Practice Address - Street 1:8 N STATE ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4038
Practice Address - Country:US
Practice Address - Phone:603-225-2512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH924152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist