Individual
ALEXA KISSELBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-2363
Mailing address
532 LORIMER ST APT 3B, BROOKLYN, NY 11211-5991
(516) 660-6904
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
702516
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
383176
NY
Other
Enumeration date
05/21/2020
Last updated
10/02/2023
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