1811656812 NPI number — MRS. ALYSSA HOLZINGER P.A.

Table of content: MRS. ALYSSA HOLZINGER P.A. (NPI 1811656812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811656812 NPI number — MRS. ALYSSA HOLZINGER P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOLZINGER
Provider First Name:
ALYSSA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811656812
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 AUBURN DR.
Provider Second Line Business Mailing Address:
STE. 350
Provider Business Mailing Address City Name:
BEACHWOOD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44122-4327
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-646-1600
Provider Business Mailing Address Fax Number:
440-646-1505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6820 RIDGE ROAD
Provider Second Line Business Practice Location Address:
STE. 204
Provider Business Practice Location Address City Name:
PARMA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44129-5647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-845-1146
Provider Business Practice Location Address Fax Number:
440-845-4023
Provider Enumeration Date:
12/17/2021

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: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 50.008152RX , 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)

  • Identifier: 0036634 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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