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General NPI Number Information
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NPI Number | 1881104511
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Entity Type | Individual
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Provider Name | ALYSSA MARIE GIBINO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/09/2017
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 1200 MCKEAN AVE
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City | CHARLEROI
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State | PA
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Zip | 15022-2141
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Country | US
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Telephone | 724-489-0866
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Fax |
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Provider Business Mailing Address
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Address Line | 14 SHANNON RD
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City | MONONGAHELA
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State | PA
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Zip | 15063-3410
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Country | US
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Telephone | 724-600-6355
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA058997
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License Number State | PA
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