Provider Demographics
NPI:1912448846
Name:SAGGESE, ALLYSA DANIELLE (NP)
Entity Type:Individual
Prefix:
First Name:ALLYSA
Middle Name:DANIELLE
Last Name:SAGGESE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 W 172ND ST
Mailing Address - Street 2:APT 4E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-2005
Mailing Address - Country:US
Mailing Address - Phone:609-338-9776
Mailing Address - Fax:
Practice Address - Street 1:1305 YORK AVE FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:646-962-5384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-10
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY717753-1163W00000X
NY308603363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse