Provider Demographics
NPI:1144908286
Name:BRUZZESE, ALESSANDRA (MSN RN, AGPCNP-C)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:BRUZZESE
Suffix:
Gender:F
Credentials:MSN RN, AGPCNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WHITEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-3931
Mailing Address - Country:US
Mailing Address - Phone:516-965-8421
Mailing Address - Fax:
Practice Address - Street 1:127 WHITEWOOD DR
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-3931
Practice Address - Country:US
Practice Address - Phone:516-965-8421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF310842-01207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine