Individual
ALYSSA BAVUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 E 37TH ST RM 208, NEW YORK, NY 10016-3256
(866) 582-7454
Mailing address
41 TAMARACK DR, CORTLANDT MANOR, NY 10567-6722
(914) 257-1962
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F309918-01
NY
Other
Enumeration date
01/10/2021
Last updated
01/10/2021
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