Provider Demographics
NPI:1881845295
Name:GURSKY, ALYSSA ANN
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:ANN
Last Name:GURSKY
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 1:57 W 57TH ST
Mailing Address - Street 2:SUITE 707
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2802
Mailing Address - Country:US
Mailing Address - Phone:212-888-2833
Mailing Address - Fax:
Practice Address - Street 1:57 W 57TH ST
Practice Address - Street 2:SUITE 707
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2802
Practice Address - Country:US
Practice Address - Phone:212-888-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043841-11223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY41-2058044OtherDENTIST