Provider Demographics
NPI:1811461809
Name:FRAGER, ALYSSA RENEE (MSN, RN-BC, AGNP-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:RENEE
Last Name:FRAGER
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Gender:F
Credentials:MSN, RN-BC, AGNP-C
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Other - Middle Name:
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Mailing Address - Street 1:800 WESTCHESTER AVE STE N715
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1369
Mailing Address - Country:US
Mailing Address - Phone:914-607-5730
Mailing Address - Fax:914-457-1195
Practice Address - Street 1:170 MAPLE AVE STE 502
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4708
Practice Address - Country:US
Practice Address - Phone:914-948-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF308931363L00000X
NY308931363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner