Provider Demographics
NPI:1124450697
Name:INGRASSIA, CHELSEA LEIGH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:LEIGH
Last Name:INGRASSIA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:LEIGH
Other - Last Name:WALLACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:PRIMARY CARE CENTER, POB 6TH FL
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-448-5547
Mailing Address - Fax:315-448-6313
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:PRIMARY CARE CENTER, POB 6TH FL
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5547
Practice Address - Fax:315-448-6313
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY620102-1163W00000X
PARN648164163W00000X
NYF338031-1363LF0000X
PASP013073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse