Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kristen Alyssa Ibrahim

Individual provider Medical Physician Assistant · NPI 1821788951

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 6B
New York, NY 10038-4715
Phone: (212) 480-9500
Show map & directions

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 number1821788951
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 11, 2023
Last updated in NPPESJune 11, 2025
Certification dateJune 11, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in New York