NPIMap

Alyssa Hannah, PA

Individual provider Active NPI Medical Physician Assistant · Reynoldsville, PA

NPI 1720095045 · NPPES record last updated Jun 8, 2016

Key facts

NPI
1720095045
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
MA-051623 (PA)
Practice address
5 N 3Rd St
Reynoldsville, PA 15851-0907
Phone
(814) 653-8222
Fax
(814) 353-9305
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA-051623PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA-051623 PA Yes

Addresses

Primary practice location

5 N 3Rd St
Reynoldsville, PA 15851-0907

Mailing address

100 Hospital Ave
Du Bois, PA 15801-1440
Phone (814) 375-3750

Other providers in Reynoldsville, PA

All providers in Reynoldsville, PA · Medical Physician Assistant in Pennsylvania

Sources for this page

Verify at the official NPI Registry.