National Provider Identifier

Alyssa G Bovalino, PA-C

Alyssa G Bovalino, PA-C is listed in the NPPES registry with a primary specialty of Physician Assistant in Ithaca, NY and a listed phone number of (315) 480-8733.

NPI 1417406398Ithaca, NYPhysician Assistant

Profile Overview

NPI
1417406398
Provider Type
Individual
Primary Specialty
Physician Assistant
Enumeration Date
October 03, 2016
Last Updated
November 04, 2016

Practice Location

  • 101 Dates Dr
  • Ithaca, NY 14850-1342

Phone: (315) 480-8733

Specialties

  • Physician Assistant (363A00000X)
Full Record
NPI
1417406398
Entity Type
Individual
Last Name
Bovalino
First Name
Alyssa
Middle Name
G
Credential
PA-C
Mailing Street Address
101 Dates Dr
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-1342
Mailing Country
US
Mailing Phone
(315) 698-1496
Practice Street Address
101 Dates Dr
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-1342
Practice Country
US
Practice Phone
(315) 480-8733
Enumeration Date
October 03, 2016
Last Updated
November 04, 2016
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physician Assistant (363A00000X)