Provider Demographics
NPI:1356797179
Name:ZABALA, ALYSSA JOYCE (RN)
Entity type:Individual
Prefix:MS
First Name:ALYSSA JOYCE
Middle Name:
Last Name:ZABALA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21430 WHITEHALL TER
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1829
Mailing Address - Country:US
Mailing Address - Phone:718-776-1760
Mailing Address - Fax:
Practice Address - Street 1:68 SCHERMERHORN ST # 80
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5005
Practice Address - Country:US
Practice Address - Phone:718-858-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY706521163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse