MEDICARE: ALEXANDRA GAVALO-YACCO DNP, FNP-BC

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	363LF0000X	Family Nurse Practitioner	F345563	NY

General Provider Information

NPI Number	:	1639787955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA GAVALO-YACCO DNP, FNP-BC

Provider Business Mailing Address
First Line	:	100 S BEDFORD RD
Second Line	:
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-3425
Country	:	US
Telephone Number	:	845-554-6620
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 INDEPENDENT WAY STE H
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-6303
Country	:	US
Telephone Number	:	845-279-2000
Fax Number	:

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

Provider Enumeration Date	:	07/22/2020
Last Update Date	:	03/04/2026

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