Provider Demographics
NPI:1255541900
Name:ALESSIO EYE MD, INC
Entity type:Organization
Organization Name:ALESSIO EYE MD, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RENO
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALESSIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-238-5030
Mailing Address - Street 1:17534 ROYALTON ROAD
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-5151
Mailing Address - Country:US
Mailing Address - Phone:440-238-5030
Mailing Address - Fax:440-238-0030
Practice Address - Street 1:17534 ROYALTON ROAD
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-5151
Practice Address - Country:US
Practice Address - Phone:440-238-5030
Practice Address - Fax:440-238-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 028593 N207W00000X
OH85164207W00000X
OH35085164207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH4168581Medicare PIN
OHPE9356771Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
OHI07966Medicare UPIN
OHA71147Medicare UPIN