MEDICARE: ALYSSA OWENS

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
1	363A00000X	Physician Assistant	MA055906	PA

General Provider Information

NPI Number	:	1942206867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA OWENS

Provider Business Mailing Address
First Line	:	167 S 15TH ST
Second Line	:	3RD FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-1537
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5115 CENTRE AVE
Second Line	:	3RD FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1301
Country	:	US
Telephone Number	:	412-647-2811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	09/23/2021

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Directions to “ ALYSSA OWENS ” Practice Location

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