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General NPI Number Information
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NPI Number | 1891265799
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Entity Type | Individual
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Provider Name | ELIAS GRAY D'ALESSIO FNP-C
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Gender | Male
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 1200 E MARSHALL ST
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City | RICHMOND
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State | VA
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Zip | 23298-5049
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Country | US
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Telephone | 804-828-3453
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Fax | 804-828-2351
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Provider Business Mailing Address
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Address Line | 3503 ROSEWOOD AVE
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City | RICHMOND
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State | VA
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Zip | 23221-3432
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Country | US
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Telephone | 202-674-1763
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024176953
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License Number State | VA
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