Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 275035-1 | NY |
NPI | 1063677482 |
---|---|
Provider Name | Dr. Alyssa M Hackett |
First Address | New York, NY 10003-4201 |
Second Address | New York, NY 10003-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 23/06/2014 |