Individual ProviderAlyssa DavisPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address51 N 39th St # 340, Philadelphia, PA 19104(215) 662-9775PECOS EnrollmentBased on the most recent information from CMS, provider Alyssa Davis is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1578082046Provider TypeIndividualFull NameDavis, AlyssaCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date9/15/2017Last Updated9/20/2019Contact InformationPractice LocationPractice Address51 N 39th St # 340, Philadelphia, PA 19104Phone(215) 662-9775FaxUnlisted FaxMailing LocationMailing Address51 N 39th St, Medical Office Building 340, Philadelphia, PA 19104-4649PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363AM0700XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseMA059770Pennsylvania