Provider Demographics
NPI:1851586986
Name:MILES, ALYSSA C (PHYSICIAN ASSISTANT)
Entity Type:Individual
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First Name:ALYSSA
Middle Name:C
Last Name:MILES
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Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:1304 BUCKLEY RD STE 200
Mailing Address - Street 2:NEPHROLOGY ASSOCIATES OF SYRACUSE, PC
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4317
Mailing Address - Country:US
Mailing Address - Phone:315-478-3311
Mailing Address - Fax:315-476-5211
Practice Address - Street 1:1304 BUCKLEY RD STE 200
Practice Address - Street 2:NEPHROLOGY ASSOCIATES OF SYRACUSE, PC
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4317
Practice Address - Country:US
Practice Address - Phone:315-478-3311
Practice Address - Fax:315-476-5211
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2015-03-30
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Provider Licenses
StateLicense IDTaxonomies
NY012015-1363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical