Individual
ALYSSA EILEEN DE SIMONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
301 E MAIN ST, BAY SHORE, NY 11706-8408
(631) 968-3000
Mailing address
72 VIOLET ST, MASSAPEQUA PARK, NY 11762-1251
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
020815-1
NY
Other
Enumeration date
06/22/2017
Last updated
06/22/2017
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