Provider Demographics
NPI:1982010252
Name:CERASUOLO, ALYSSA
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:CERASUOLO
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 1:5 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-3404
Mailing Address - Country:US
Mailing Address - Phone:914-355-1608
Mailing Address - Fax:
Practice Address - Street 1:145 HUGUENOT ST
Practice Address - Street 2:4TH FLOOR, SUITE 404
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5200
Practice Address - Country:US
Practice Address - Phone:914-251-0905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1363683174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist