Healthcare Provider Details

I. General information

NPI: 1669117313
Provider Name (Legal Business Name): ALYSSA ASHLEY KRAJEWSKI FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSSA ASHLEY HUGHES FNP-C

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 ELLICOTT ST
BUFFALO NY
14203-1021
US

IV. Provider business mailing address

818 ELLICOTT ST
BUFFALO NY
14203-1021
US

V. Phone/Fax

Practice location:
  • Phone: 716-323-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number349135
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: