Provider Demographics
NPI:1669589743
Name:ZOLLI, ALEXANDER FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:FRANCIS
Last Name:ZOLLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2173 N RIDGE RD E
Mailing Address - Street 2:SUITE A
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-3400
Mailing Address - Country:US
Mailing Address - Phone:440-277-5077
Mailing Address - Fax:440-277-6696
Practice Address - Street 1:2173 N RIDGE RD E
Practice Address - Street 2:SUITE A
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3400
Practice Address - Country:US
Practice Address - Phone:440-277-5077
Practice Address - Fax:440-277-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053879208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0636306Medicaid
OHC58335Medicare UPIN
OH0636306Medicaid