Individual
ALYSSA LEOKADIA THAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(419) 509-6660
Mailing address
455 W 37TH ST APT 1603, NEW YORK, NY 10018-4789
(419) 509-6660
Taxonomy
Speciality
Code
Description
License number
State
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
382944
NY
Other
Enumeration date
01/11/2019
Last updated
05/04/2020
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