Provider Demographics
NPI:1710439930
Name:POMERICO, ALYSSA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:POMERICO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 WILMINGTON RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1231
Mailing Address - Country:US
Mailing Address - Phone:724-598-0000
Mailing Address - Fax:724-598-8000
Practice Address - Street 1:2815 WILMINGTON RD
Practice Address - Street 2:SUITE 2
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1231
Practice Address - Country:US
Practice Address - Phone:724-598-0000
Practice Address - Fax:724-598-8000
Is Sole Proprietor?:No
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC014734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist