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ALYSSA MANCUSO VARGAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-0866
Mailing address
120 EDGEBROOK LN, ROCHESTER, NY 14617-4117
(585) 721-6407

Taxonomy

Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
F340306-1
NY
363LP0200X
Pediatric Nurse Practitioner
340306
NY

Other

Enumeration date
02/08/2016
Last updated
06/29/2023
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