Healthcare Provider Details

I. General information

NPI: 1679071831
Provider Name (Legal Business Name): ALYSSA GABRIELLE WEINSTEIN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 SANDUSKY RD
NEW CITY NY
10956-6917
US

IV. Provider business mailing address

240 E 76TH ST APT 11S
NEW YORK NY
10021-2949
US

V. Phone/Fax

Practice location:
  • Phone: 845-825-4819
  • Fax:
Mailing address:
  • Phone: 845-825-4819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number013063
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number013063
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: