Provider Demographics
NPI:1275190415
Name:MAHER, ALYSSA (MTBC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MAHER
Suffix:
Gender:F
Credentials:MTBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 TINA CT
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5343
Mailing Address - Country:US
Mailing Address - Phone:410-804-0439
Mailing Address - Fax:
Practice Address - Street 1:2001 TINA CT
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5343
Practice Address - Country:US
Practice Address - Phone:410-804-0439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14080225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty