Healthcare Provider Details

I. General information

NPI: 1194942656
Provider Name (Legal Business Name): ALLEGRO MEDICAL ARTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4866 WUNNENBERG WAY
WEST CHESTER OH
45069-4863
US

IV. Provider business mailing address

1601 MOTOR INN DR SUITE 240
GIRARD OH
44420-2420
US

V. Phone/Fax

Practice location:
  • Phone: 513-942-6130
  • Fax: 513-942-6139
Mailing address:
  • Phone: 330-759-6750
  • Fax: 330-759-6755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number3
License Number State

VIII. Authorized Official

Name: KRISTIE ANNE DEPASCALE
Title or Position: RN
Credential:
Phone: 330-759-6750