Individual provider · Type 1 NPI

Alyssa L. Detommaso, PA-C

Physician Assistant · Fort Wayne, IN

NPI number 1801339791 Active

Practice location

7988 W Jefferson Blvd
Fort Wayne, IN 46804-4140

Call (260) 432-4400 Map

Fax (260) 432-2723

Mailing address

2518 E Dupont Rd
Fort Wayne, IN 46825-1675

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X10002198A (IN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1801339791

Alyssa L. Detommaso, PA-C's National Provider Identifier is 1801339791, issued on Nov 23, 2016. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Oct 6, 2026.