Provider Demographics
NPI:1831780220
Name:YOUNG, ALYSSA L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:L
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ALYSSA
Other - Middle Name:L
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:7444 MALVERN AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19151-2921
Mailing Address - Country:US
Mailing Address - Phone:973-943-7595
Mailing Address - Fax:
Practice Address - Street 1:863 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1057
Practice Address - Country:US
Practice Address - Phone:610-361-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist