Provider Demographics
NPI:1568279891
Name:SITTERLY, ALESSANDRA
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:SITTERLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 EASTVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-5206
Mailing Address - Country:US
Mailing Address - Phone:518-935-5478
Mailing Address - Fax:
Practice Address - Street 1:26 EASTVIEW RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-5206
Practice Address - Country:US
Practice Address - Phone:518-935-5478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30003580235Z00000X
NY035059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty