Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F304351 | NY |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 428636-1 | NY |
N | 363LP2300X | Nurse Practitioner - Primary Care | NP-647 | ID |
NPI | 1124011838 |
---|---|
Provider Name | Ms. Mauricia P Alo |
First Address | Mount Kisco, NY 10549-3446 |
Second Address | Poughkeepsie, NY 12601-1361 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2005 |
Last Update Date | 14/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03017585 | (05) | NY |