Provider Demographics
NPI:1104237957
Name:TRYZNA, ALLA (NP)
Entity type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:TRYZNA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALLA
Other - Middle Name:
Other - Last Name:BABAKHINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:4915 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3301
Mailing Address - Country:US
Mailing Address - Phone:718-851-3700
Mailing Address - Fax:
Practice Address - Street 1:5923 STRICKLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6435
Practice Address - Country:US
Practice Address - Phone:718-535-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY606337163W00000X
NY309940363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse