Provider Demographics
NPI:1760104947
Name:YEZARSKI, ALISON L
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:L
Last Name:YEZARSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 ALINDA AVE
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-2325
Mailing Address - Country:US
Mailing Address - Phone:631-702-5359
Mailing Address - Fax:
Practice Address - Street 1:43 ALINDA AVE
Practice Address - Street 2:
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-2325
Practice Address - Country:US
Practice Address - Phone:631-702-5359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY344263164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse