MEDICARE: ALYSSA MCMANUS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	720800	NY

General Provider Information

NPI Number	:	1134783327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA MCMANUS

Provider Business Mailing Address
First Line	:	2029B HARTLAND RD
Second Line	:
City	:	APPLETON
State	:	NY
Zip	:	14008-9621
Country	:	US
Telephone Number	:	716-514-3247
Fax Number	:

Provider Business Practice Location Address
First Line	:	2029B HARTLAND RD
Second Line	:
City	:	APPLETON
State	:	NY
Zip	:	14008-9621
Country	:	US
Telephone Number	:	716-514-3247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2019
Last Update Date	:	01/29/2024

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Directions to “ ALYSSA MCMANUS ” Practice Location

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