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NPI Code Detail

MEDICARE: ALYSSA MILLIE IRYAMI

MEDICARE: ALYSSA MILLIE IRYAMI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantNY

General Provider Information

NPI Number : 1073446795
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA MILLIE IRYAMI
Provider Business Mailing Address
First Line : 32 S OAKS BLVD
Second Line :
City : PLAINVIEW
State : NY
Zip : 11803-1935
Country : US
Telephone Number : 516-697-6974
Fax Number :
Provider Business Practice Location Address
First Line : 177 FORT WASHINGTON AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3733
Country : US
Telephone Number : 212-305-5098
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2026
Last Update Date : 06/03/2026

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Directions to “ ALYSSA MILLIE IRYAMI ” Practice Location

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