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General NPI Number Information
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NPI Number | 1669870325
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Entity Type | Individual
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Provider Name | ALYSSA GOPMAN PA
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Gender | Female
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 161 MADISON AVE RM 6SE
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City | NEW YORK
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State | NY
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Zip | 10016-5454
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Country | US
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Telephone | 212-677-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 15 WILLIAM ST APT 14G
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City | NEW YORK
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State | NY
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Zip | 10005-2932
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Country | US
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Telephone | 561-635-7882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 018289
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License Number State | NY
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