Provider Demographics
NPI:1699245829
Name:SIEGEL, ALISON ANNA (MFC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:ANNA
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MFC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7370 NW 35TH CT
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4918
Mailing Address - Country:US
Mailing Address - Phone:954-868-4159
Mailing Address - Fax:
Practice Address - Street 1:7370 NW 35TH CT
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4918
Practice Address - Country:US
Practice Address - Phone:954-868-4159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3747P1801XMedicaid