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Individual

MRS. ALISA MARIE ALBANESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5111
Mailing address
5348 STRAWFLOWER DRIVE, NORTH SYRACUSE, NY 13212-1220
(315) 458-1692

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
013067
NY
363AM0700X
Medical Physician Assistant
Primary
P67542
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03328383
NY
Enumeration date
10/17/2008
Last updated
11/14/2011
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