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General NPI Number Information
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NPI Number | 1700465952
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Entity Type | Individual
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Provider Name | ALESSANDRA MAYO
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Gender | Female
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 3241 MOUNT CARMEL RD
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City | CINCINNATI
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State | OH
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Zip | 45244-4315
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Country | US
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Telephone | 513-753-0044
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Fax |
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Provider Business Mailing Address
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Address Line | 501 S PRESTON ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.026756
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License Number State | OH
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