Provider Demographics
NPI:1720229495
Name:ALESE, MABEL E (RN)
Entity Type:Individual
Prefix:MRS
First Name:MABEL
Middle Name:E
Last Name:ALESE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 BEACH 31ST ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2014
Mailing Address - Country:US
Mailing Address - Phone:718-868-1619
Mailing Address - Fax:
Practice Address - Street 1:316 BEACH 65TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11692-1425
Practice Address - Country:US
Practice Address - Phone:718-474-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY597793163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse