Provider Demographics
NPI:1497057947
Name:ALESSI, CRYSTAL ELIZABETH (LPN)
Entity Type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:ELIZABETH
Last Name:ALESSI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 DARE RD
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2008
Mailing Address - Country:US
Mailing Address - Phone:631-965-0671
Mailing Address - Fax:
Practice Address - Street 1:146 DARE RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2008
Practice Address - Country:US
Practice Address - Phone:631-965-0671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303562-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse