Luciano Domenico Alonzi

Individual provider Active NPI Athletic Trainer · University Park, PA

NPI 1992208797 · NPPES record last updated Apr 29, 2021

Key facts

NPI
1992208797
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
276 Recreation BLDG BLDG
University Park, PA 16802-5701
Phone
(814) 863-0442
NPI assigned
Mar 17, 2018
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

276 Recreation BLDG BLDG
University Park, PA 16802-5701

Mailing address

3093 New Williamsburg Dr
Schenectady, NY 12303-5384

Other providers in University Park, PA

All providers in University Park, PA · Athletic Trainer in Pennsylvania

Sources for this page

Verify at the official NPI Registry.