Provider Demographics
NPI:1134783327
Name:MCMANUS, ALYSSA
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MCMANUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:PETRIZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2029B HARTLAND RD
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:NY
Mailing Address - Zip Code:14008-9621
Mailing Address - Country:US
Mailing Address - Phone:716-514-3247
Mailing Address - Fax:
Practice Address - Street 1:2029B HARTLAND RD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:NY
Practice Address - Zip Code:14008-9621
Practice Address - Country:US
Practice Address - Phone:716-514-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY720800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse