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Individual

DR. GRACE ALESSI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
35589
CO
207R00000X
Internal Medicine Physician
Primary
35589
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01355890
CO
05
118112200
WY
01
P00944656
MEDICARE RAILROAD CARRIER PTAN
CO
Enumeration date
07/03/2006
Last updated
09/01/2011
Update your record

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