Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 013063 | NY |
Y | 111NI0013X | Independent Medical Examiner | 013063 | NY |
NPI | 1679071831 |
---|---|
Provider Name | Dr. Alyssa Gabrielle Bachner |
First Address | New City, NY 10956-6917 |
Second Address | New City, NY 10956-6917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2018 |
Last Update Date | 23/01/2018 |