MEDICARE: ALEXIS ZOLLO PHD

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	103T00000X	Psychologist	PS020544	PA

General Provider Information

NPI Number	:	1851240402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS ZOLLO PHD

Provider Business Mailing Address
First Line	:	1237 S 20TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2947
Country	:	US
Telephone Number	:	215-901-3712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1237 S 20TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2947
Country	:	US
Telephone Number	:	215-901-3712
Fax Number	:

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

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “ ALEXIS ZOLLO PHD” Practice Location

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