Healthcare Provider Details

I. General information

NPI: 1851419956
Provider Name (Legal Business Name): ALESSIO OPTICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17534 ROYALTON ROAD
STRONGSVILLE OH
44136-5151
US

IV. Provider business mailing address

17534 ROYALTON ROAD
STRONGSVILLE OH
44136-5151
US

V. Phone/Fax

Practice location:
  • Phone: 440-238-1515
  • Fax: 440-238-0030
Mailing address:
  • Phone: 440-238-1515
  • Fax: 440-238-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number47905
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35085164
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number18-373349
License Number StateOH

VIII. Authorized Official

Name: MR. RENO L ALESSIO
Title or Position: PRESIDENT
Credential: MD
Phone: 440-238-5030