MEDICARE: ALYSSA KRISTA LIM RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	753183-01	NY

General Provider Information

NPI Number	:	1992660450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA KRISTA LIM RN

Provider Business Mailing Address
First Line	:	900 MERCHANTS CONCOURSE STE LL06
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-5144
Country	:	US
Telephone Number	:	516-565-6322
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 MERCHANTS CONCOURSE STE LL06
Second Line	:
City	:	WESTBURY
State	:	NY
Zip	:	11590-5144
Country	:	US
Telephone Number	:	516-565-6322
Fax Number	:	877-717-2778

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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