Healthcare Provider Details

I. General information

NPI: 1063363414
Provider Name (Legal Business Name): AALIYAH KERR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 GRAND CONCOURSE
BRONX NY
10453-4303
US

IV. Provider business mailing address

2015 GRAND CONCOURSE
BRONX NY
10453-4303
US

V. Phone/Fax

Practice location:
  • Phone: 631-921-6598
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number358285
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: