Provider Demographics
NPI:1073294377
Name:ABBRUZZI DAVIS, ARIAS ALEA INDIGO (NP-BC)
Entity Type:Individual
Prefix:DR
First Name:ARIAS
Middle Name:ALEA INDIGO
Last Name:ABBRUZZI DAVIS
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 HENRY ST APT 703
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-6488
Mailing Address - Country:US
Mailing Address - Phone:347-260-2007
Mailing Address - Fax:
Practice Address - Street 1:19 W 21ST ST STE 10003
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6805
Practice Address - Country:US
Practice Address - Phone:917-740-5287
Practice Address - Fax:888-396-3996
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF405172-01363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health