Kristen Alyssa Ibrahim
Kristen Alyssa Ibrahim is a Physician Assistant in New York, New York. Qualified in 2023, 3 years ago. Practices as a sole proprietor.
- Years since qualifying
- 3
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
125 Maiden Ln Rm 6BNew York, NY 10038-4715
Phone: (212) 480-9500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X |
Record details
| NPI number | 1821788951 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | May 11, 2023 |
| Last updated in NPPES | June 11, 2025 |
| Certification date | June 11, 2025 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2023 (3 years in practice) |
| Accepts Medicare assignment | Not indicated |
| Practice locations | 2 on file with Medicare |
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