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Individual

ALYSSA GILLEGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
77 LAFAYETTE PL STE 302, GREENWICH, CT 06830-5426
(203) 863-4250
(203) 863-4249
Mailing address
PO BOX 415126, BOSTON, MA 02241-5126
(203) 863-4250
(203) 863-4249

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
056739
CT
208600000X
Surgery Physician
252073
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
090923000071
FIDELIS
01
25207301
HEALTHFIRST
05
390200000X
NY
01
GA2073
ATLANTIS
01
P4055272
OXFORD
Enumeration date
09/18/2007
Last updated
11/13/2017
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