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Contact Information

ALYSSA K MOORE, PA-C
10500 MONTGOMERY RD
MONTGOMERY, OH45242-4402
 Phone: 513-865-5552
 Fax: 513-865-2227
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ALYSSA K MOORE · (Female)

NPI # 1114671765
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 02/11/2022
Last updated 03/01/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 50.0007057
  • OH License # 50.007057RX
  • OH Medicaid 0462231
Hospital affiliation(s)
  • BETHESDA NORTH - (Acute Care)
    10500 MONTGOMERY ROAD
    CINCINNATI, OH 45242
  • GOOD SAMARITAN HOSPITAL - (Acute Care)
    375 DIXMYTH AVENUE
    CINCINNATI, OH 45220
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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