Provider Demographics
NPI:1396988465
Name:LE, ALYSSA LILLO (MD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:LILLO
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALYSSA
Other - Middle Name:JENNIFER
Other - Last Name:LILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10541 WINTERSWEET CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-2500
Mailing Address - Country:US
Mailing Address - Phone:860-604-8456
Mailing Address - Fax:
Practice Address - Street 1:5657 S HIMALAYA ST
Practice Address - Street 2:STE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5307
Practice Address - Country:US
Practice Address - Phone:303-699-6200
Practice Address - Fax:720-974-7175
Is Sole Proprietor?:No
Enumeration Date:2009-04-19
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0057347208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics