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General NPI Number Information
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NPI Number | 1528638806
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Entity Type | Individual
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Provider Name | ALYSSA FILANGERI
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Gender | Female
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 153 A ST
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City | JACKSONVILLE
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State | NC
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Zip | 28540
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Country | US
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Telephone | 910-451-1658
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Fax |
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Provider Business Mailing Address
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Address Line | 1 PESCE CT
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City | BOHEMIA
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State | NY
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Zip | 11716-2191
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Country | US
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Telephone | 631-559-6799
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401417486
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License Number State | VA
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