Healthcare Provider Details

I. General information

NPI: 1871409888
Provider Name (Legal Business Name): ANA LISSETTE ALIAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 STUYVESANT AVE
LYNDHURST NJ
07071-1017
US

IV. Provider business mailing address

52 STUYVESANT AVE
LYNDHURST NJ
07071-1017
US

V. Phone/Fax

Practice location:
  • Phone: 551-380-0798
  • Fax:
Mailing address:
  • Phone: 551-380-0798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number1610110
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: