Provider Demographics
NPI:1558067587
Name:OPIARY, ALYSSA (PTA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:OPIARY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-1949
Mailing Address - Country:US
Mailing Address - Phone:570-208-2787
Mailing Address - Fax:570-208-2788
Practice Address - Street 1:160 S MARKET ST
Practice Address - Street 2:
Practice Address - City:NANTICOKE
Practice Address - State:PA
Practice Address - Zip Code:18634-2315
Practice Address - Country:US
Practice Address - Phone:570-258-2365
Practice Address - Fax:570-258-2395
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI003602225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant