Individual
ALYSSA J INTERNICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 SUMMIT ST, STATEN ISLAND, NY 10307-1830
(646) 957-4086
Mailing address
18 SUMMIT ST, STATEN ISLAND, NY 10307-1830
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
807643
NY
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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