Individual
ALYSSA-RAE MITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
22 E 21ST ST FL 2F, NEW YORK, NY 10010-7251
(212) 260-6106
Mailing address
455 10TH AVE APT 37B, NEW YORK, NY 10018-0910
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
063368
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/03/2022
Last updated
04/28/2024
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