Alyssa-Nycole Labua
Specialist in Middle Island, NY. Individual provider (NPI-1).
NPI number1659000412
StatusActive
Last updated in NPPESJun 7, 2022
Details
- NPI
- 1659000412
- Entity type
- Individual (NPI-1)
- Name
- Alyssa-Nycole Labua
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 7, 2022
- Certification date
- Jun 7, 2022
- Last updated
- Jun 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | NY | Yes |
Practice location
35 Longwood RdMiddle Island, NY 11953-2045
Phone 631-924-0008
Mailing address
Po Box 12Middle Island, NY 11953-0012
Phone 631-924-0008
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