Individual
ALYSSA KANAGAKI GREENLEAF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
462 QUEEN ST STE 303, SOUTHINGTON, CT 06489-1801
(860) 224-5672
Mailing address
462 QUEEN ST, STE 303, SOUTHINGTON, CT 06489-1801
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4051
CT
363AM0700X
Medical Physician Assistant
5169
MA
Other
Enumeration date
10/09/2014
Last updated
05/22/2019
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