Healthcare Provider Details

I. General information

NPI: 1528793205
Provider Name (Legal Business Name): ALYSSA ANN GASSER OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 ROUTE 611
SWIFTWATER PA
18370-7787
US

IV. Provider business mailing address

2055 ROUTE 611
SWIFTWATER PA
18370-7787
US

V. Phone/Fax

Practice location:
  • Phone: 570-579-4793
  • Fax:
Mailing address:
  • Phone: 570-579-4793
  • Fax: 570-839-2576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOEG003928
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License NumberOEG003928
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG003928
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: