1134185747 NPI number — DR. ALLISON AVERY MACEROLLO MD

Table of content: DR. ALLISON AVERY MACEROLLO MD (NPI 1134185747)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134185747 NPI number — DR. ALLISON AVERY MACEROLLO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACEROLLO
Provider First Name:
ALLISON
Provider Middle Name:
AVERY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
AVERY
Provider Other First Name:
ALLISON
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1134185747
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 ACKERMAN RD STE 2120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43202-1559
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-293-5123
Provider Business Mailing Address Fax Number:
614-293-4980

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
543 TAYLOR AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-293-5123
Provider Business Practice Location Address Fax Number:
614-293-4980
Provider Enumeration Date:
04/22/2006

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: 207Q00000X , with the licence number:  35082968 , 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)





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