Provider Demographics
NPI:1073351581
Name:DUROSS, ALYSSA BELLA
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:BELLA
Last Name:DUROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 HARVARD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3181
Mailing Address - Country:US
Mailing Address - Phone:315-723-9085
Mailing Address - Fax:
Practice Address - Street 1:2099 W RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-2728
Practice Address - Country:US
Practice Address - Phone:585-434-7767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist