Provider Demographics
NPI:1700568490
Name:CHOO, ALYSSA KARREN (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KARREN
Last Name:CHOO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1400 FOREST GLEN RD STE 400
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1482
Mailing Address - Country:US
Mailing Address - Phone:301-589-3324
Mailing Address - Fax:301-681-7575
Practice Address - Street 1:1400 FOREST GLEN RD STE 400
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1482
Practice Address - Country:US
Practice Address - Phone:301-589-3324
Practice Address - Fax:301-681-7575
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110009739363A00000X
MDC0009457363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant