Provider Demographics
NPI:1376686386
Name:SUTTER, ALICE STURM (FNP)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:STURM
Last Name:SUTTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 W 180TH ST
Mailing Address - Street 2:#51
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5527
Mailing Address - Country:US
Mailing Address - Phone:212-927-5062
Mailing Address - Fax:
Practice Address - Street 1:NORTH CENTRAL BRONX HOSPITAL
Practice Address - Street 2:3424 KOSSUTH AVE. 10A SPECIAL CARE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-519-4884
Practice Address - Fax:718-519-5077
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF331312363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily