Healthcare Provider Details

I. General information

NPI: 1205865094
Provider Name (Legal Business Name): ALLISON MARIA ZIBELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

925 CHESTNUT ST SUITE 320A
PHILADELPHIA PA
19107-4216
US

IV. Provider business mailing address

1 W ELM ST STE 100
CONSHOHOCKEN PA
19428-4108
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-8874
  • Fax: 215-955-2340
Mailing address:
  • Phone: 215-955-8874
  • Fax: 215-955-2340

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number25MA10268600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD066005L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: