MEDICARE: MORGAN ALEXANDRA DYSERT APRN, PMHNP-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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	17542	CT

General Provider Information

NPI Number	:	1780517912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN ALEXANDRA DYSERT APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	274 MADISON AVE RM 1501
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-0701
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	274 MADISON AVE RM 1501
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-0701
Country	:	US
Telephone Number	:	212-203-1773
Fax Number	:

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

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

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