Individual
ALIA ALYN YESALAVAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
150 MUNDY ST, MAC IV BUILDING, WILKES BARRE, PA 18702-6830
(570) 824-0930
(570) 824-7755
Mailing address
47 ROCKLEDGE DR, MOUNTAIN TOP, PA 18707-1953
(570) 474-2126
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP010019
PA
Other
Enumeration date
11/03/2008
Last updated
11/30/2009
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