Provider Demographics
NPI:1679071831
Name:WEINSTEIN, ALYSSA GABRIELLE (DC)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:GABRIELLE
Last Name:WEINSTEIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 E 76TH ST APT 11S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2949
Mailing Address - Country:US
Mailing Address - Phone:845-825-4819
Mailing Address - Fax:
Practice Address - Street 1:18 SANDUSKY RD
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-6917
Practice Address - Country:US
Practice Address - Phone:845-825-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013063111N00000X, 111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111N00000XChiropractic ProvidersChiropractor