NPI Code Detail JSON Logo

1730965732 NPI number — ALYSSA FERNANDEZ PT

NPI Number: 1730965732
Health Care Provider/Practitioner: ALYSSA FERNANDEZ PT

Information about “1730965732” NPI (ALYSSA FERNANDEZ PT) exists in 1730965732 in HTML format HTML  |  1730965732 in plain Text format TXT  |  1730965732 in PDF (Portable Document Format) PDF  |  1730965732 in an XML format XML  formats.

NPI Number : 1730965732 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1730965732",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FERNANDEZ",
    "FirstName": "ALYSSA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PT",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ORRICO",
    "OtherFirstName": "ALYSSA",
    "OtherMiddleName": "MARIE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DPT",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "1721 ALLENS LN STE 101",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WILMINGTON",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28403-3662",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "910-256-4442",
    "MailingAddressFaxNumber": "910-256-4443",
    "FirstLinePracticeLocationAddress": "1721 ALLENS LN STE 101",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WILMINGTON",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28403-3662",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "910-256-4442",
    "PracticeLocationAddressFaxNumber": "910-256-4443",
    "EnumerationDate": "09/05/2023",
    "LastUpdateDate": "10/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2251X0800X",
          "TaxonomyName": "Orthopedic Physical Therapist",
          "LicenseNumber": "P24167",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "051022",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.