Individual
ALYSSA B LAESER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
44330 MERCURE CIR STE 240E, DULLES, VA 20166-2024
(703) 727-0523
(703) 935-0330
Mailing address
1300 PICCARD DR, STE 202, ROCKVILLE, MD 20850-4303
(301) 921-7900
(301) 921-7915
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001237
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12196770
CAQH
—
Enumeration date
06/22/2006
Last updated
07/08/2021
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