Provider Demographics
NPI:1518917558
Name:NEUMAN, ALISSA YVETTE (OD)
Entity Type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:YVETTE
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ALISSA
Other - Middle Name:YVETTE
Other - Last Name:LOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:4102 PINION DR
Mailing Address - Street 2:
Mailing Address - City:USAF ACADEMY
Mailing Address - State:CO
Mailing Address - Zip Code:80840-2502
Mailing Address - Country:US
Mailing Address - Phone:719-333-0525
Mailing Address - Fax:
Practice Address - Street 1:4102 PINION DR
Practice Address - Street 2:
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-2502
Practice Address - Country:US
Practice Address - Phone:719-333-5286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1907152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08019077Medicaid
CO41173Medicare ID - Type Unspecified
COU67182Medicare UPIN