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NPI Code Detail

MEDICARE: ALYSSA MANALO

MEDICARE:   ALYSSA  MANALO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist24883NV

General Provider Information

NPI Number : 1629930573
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MANALO
Provider Business Mailing Address
First Line : 7963 BARNTUCKET AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-4773
Country : US
Telephone Number : 702-964-5814
Fax Number :
Provider Business Practice Location Address
First Line : 7963 BARNTUCKET AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-4773
Country : US
Telephone Number : 702-964-5814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ ALYSSA MANALO ” Practice Location

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