Healthcare Provider Details

I. General information

NPI: 1760949648
Provider Name (Legal Business Name): ALYSSA FISHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 W MARKET ST
AKRON OH
44303-1411
US

IV. Provider business mailing address

611 W MARKET ST
AKRON OH
44303-1411
US

V. Phone/Fax

Practice location:
  • Phone: 330-996-4600
  • Fax: 330-564-2469
Mailing address:
  • Phone: 330-996-4600
  • Fax: 330-564-2469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: