MEDICARE: ALEX NUCERINO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	AT007114	OH

General Provider Information

NPI Number	:	1437894862
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX NUCERINO

Provider Business Mailing Address
First Line	:	283 E 1ST AVE STE 105
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43215-2184
Country	:	US
Telephone Number	:	513-503-6744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 BLACK AND GOLD BLVD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2091
Country	:	US
Telephone Number	:	513-503-6744
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2022
Last Update Date	:	12/18/2025

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Directions to “ ALEX NUCERINO ” Practice Location

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