1467641324 NPI number — MRS. ALICIA GANELLI N.P.

Table of content: MRS. ALICIA GANELLI N.P. (NPI 1467641324)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467641324 NPI number — MRS. ALICIA GANELLI N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GANELLI
Provider First Name:
ALICIA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRANCISCO
Provider Other First Name:
ALICIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
N.P.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467641324
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 ARCH ST. #300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AKRON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44304
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-376-7000
Provider Business Mailing Address Fax Number:
330-253-0853

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 ARCH ST. #300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AKRON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-376-7000
Provider Business Practice Location Address Fax Number:
330-253-0853
Provider Enumeration Date:
10/17/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  APRN.CNP.09521 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)