Provider Demographics
NPI:1821110917
Name:ALTSCHULLER, ALISON (APRN-BC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:ALTSCHULLER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EMBARCADERO CTR STE 1900
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-3723
Mailing Address - Country:US
Mailing Address - Phone:415-658-6791
Mailing Address - Fax:
Practice Address - Street 1:919 3RD AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3902
Practice Address - Country:US
Practice Address - Phone:212-530-0630
Practice Address - Fax:212-867-4353
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA265854163W00000X
MARN265854363LA2200X
NY304793363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY00695941Medicaid
NY331952Medicare Oscar/Certification
NYW6L1111Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NYG10000410Medicare Oscar/Certification