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NPI Code Detail

MEDICARE: ALYSA GLUCKSMAN

MEDICARE: ALYSA GLUCKSMAN
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
1104100000XSocial Worker093273-1NY

General Provider Information

NPI Number : 1629465000
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSA GLUCKSMAN
Provider Business Mailing Address
First Line : 4330 BYRON AVE
Second Line :
City : BRONX
State : NY
Zip : 10466-1608
Country : US
Telephone Number : 718-324-7526
Fax Number :
Provider Business Practice Location Address
First Line : 4330 BYRON AVE
Second Line :
City : BRONX
State : NY
Zip : 10466-1608
Country : US
Telephone Number : 718-324-7526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2015
Last Update Date : 04/23/2015

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Directions to “ ALYSA GLUCKSMAN ” Practice Location

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