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General NPI Number Information
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NPI Number | 1619334968
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Entity Type | Individual
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Provider Name | ALYSSE NNAMANI
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Gender | Female
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Dates
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Enumeration Date | 01/18/2016
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 489 MOUNT AUBURN ST
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City | WATERTOWN
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State | MA
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Zip | 02472-4194
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Country | US
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Telephone | 617-383-7786
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Fax |
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Provider Business Mailing Address
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Address Line | 24 FRANKLIN ST
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City | BELMONT
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State | MA
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Zip | 02478-2345
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Country | US
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Telephone | 330-559-1937
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 19776
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License Number State | MA
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