Provider Demographics
NPI:1144081795
Name:AYALA, ALEJANDRO JOSUE
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:JOSUE
Last Name:AYALA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BLOOMFIELD AVE # 2875
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1545
Mailing Address - Country:US
Mailing Address - Phone:860-796-6820
Mailing Address - Fax:
Practice Address - Street 1:628 HEBRON AVE STE 500
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-5046
Practice Address - Country:US
Practice Address - Phone:860-647-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter