Individual
ALIZZA RETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4514 16TH AVE FL 4, BROOKLYN, NY 11204-1101
(718) 407-7300
Mailing address
620 FOSTER AVE STE 200, BROOKLYN, NY 11230-1399
(718) 407-7300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
017378
NY
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06139179
—
NY
Enumeration date
04/29/2014
Last updated
01/12/2021
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