MEDICARE: MICHAEL JOSEPH RAYMOND ALLOCCA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	BH007441	PA

General Provider Information

NPI Number	:	1285580027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JOSEPH RAYMOND ALLOCCA

Provider Business Mailing Address
First Line	:	824 N 27TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-1806
Country	:	US
Telephone Number	:	215-514-4642
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 HAMILTON ST STE C100A
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3863
Country	:	US
Telephone Number	:	856-346-0005
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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