Organization
ALYSSA DAVIS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY FEIG LBCBA (EXECUTIVE DIRECTOR)
(646) 741-3748
Entity
Organization
Contact information
Practice address
39 LORI WAY, HAUPPAUGE, NY 11788-4301
(917) 842-6189
Mailing address
39 LORI WAY, HAUPPAUGE, NY 11788-4301
(917) 842-6189
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10300000
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10300000
HEALTH CARE
NY
01
—
D
AUTISM PROVIDER
NY
Enumeration date
10/03/2014
Last updated
10/03/2014
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