Healthcare Provider Details

I. General information

NPI: 1982063434
Provider Name (Legal Business Name): ALYSSA MARIE ARAGOSA PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2016
Last Update Date: 07/27/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MCCLELLAN ST
SCHENECTADY NY
12304-1009
US

IV. Provider business mailing address

1101 NOTT STREET WOUND CARE CENTER
SCHENECTADY NY
12308
US

V. Phone/Fax

Practice location:
  • Phone: 518-347-5442
  • Fax: 518-347-5330
Mailing address:
  • Phone: 518-347-5442
  • Fax: 518-347-5330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number019491
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: