| Provider / Organization | NPI | Date Certified |
|---|---|---|
| ALYSSA NICOLE BRENEMAN | 1578143954 | 2021-04-10 |
Alyssa Nicole Breneman is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1578143954. Registration indicates Alyssa Nicole Breneman is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Alyssa Nicole Breneman |
| Practice Office Address | 630 W 168TH ST NEW YORK, NY US |
| Practice Office Telephone | 2123052862 |
| Mailing Address | 630 W 168TH ST NEW YORK, NY 100323725 US |
| Business Telephone | 2123052862 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |