Most Relevant Information
Provider Data
| NPI Number: | 1003523754 |
| Provider Name: | ALEXANDRA ISABELLA YACUB |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | F350635 |
Most Important Dates
| Enumeration Date: | 11/02/2022 |
| Last Updated: | 09/19/2024 |
Provider Practice Location
1021 BROADWAY ST
BUFFALO
NY
142121460
Practice Location Phone/Fax
| Phone: | 7165293020 |
| Fax: | 7165293040 |
Provider Mailing Location
1021 BROADWAY ST
BUFFALO
NY
142121460
Provider Mailing Phone/Fax
| Phone: | 7165293020 |
| Fax: | 7165293040 |