Healthcare Provider Details

I. General information

NPI: 1205281920
Provider Name (Legal Business Name): ALISSA BRETTE MCINERNEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2016
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 3RD AVE STE C1
BRONX NY
10455-4066
US

IV. Provider business mailing address

2825 3RD AVE STE C1
BRONX NY
10455-4066
US

V. Phone/Fax

Practice location:
  • Phone: 718-957-8466
  • Fax: 607-327-5838
Mailing address:
  • Phone: 718-957-8466
  • Fax: 607-327-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number298202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: