Provider Demographics
NPI:1245834704
Name:ALESSI, MICHAEL CHARLES
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:CHARLES
Last Name:ALESSI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2323
Mailing Address - Country:US
Mailing Address - Phone:814-866-9834
Mailing Address - Fax:814-866-3585
Practice Address - Street 1:1409 W 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2323
Practice Address - Country:US
Practice Address - Phone:814-866-9834
Practice Address - Fax:814-866-3585
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAF02844237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter