Provider Demographics
NPI:1356082424
Name:AUERBACH, ALYSSA M (DO)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:AUERBACH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-3004
Mailing Address - Country:US
Mailing Address - Phone:516-476-9066
Mailing Address - Fax:
Practice Address - Street 1:967 NORTH BROADWAY
Practice Address - Street 2:MEDICAL EDUCATION DEPT.
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701
Practice Address - Country:US
Practice Address - Phone:914-798-8971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program