Healthcare Provider Details

I. General information

NPI: 1679915730
Provider Name (Legal Business Name): MRS. ALLISON MARGOTTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2013
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2722 N HANCOCK ST UNIT 304
PHILADELPHIA PA
19133-3539
US

IV. Provider business mailing address

35 SUMMIT AVE
PAOLI PA
19301-1135
US

V. Phone/Fax

Practice location:
  • Phone: 215-469-1668
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW141027
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL05889600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: