Individual
DR. MARIO ALONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1011 BROOKSIDE RD, SUITE 305, ALLENTOWN, PA 18106-9020
(610) 437-2277
Mailing address
1011 BROOKSIDE RD, SUITE 305, ALLENTOWN, PA 18106-9020
(610) 437-2277
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS002534L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01522802
CAPITAL BLUE CROSS ID
PA
01
—
089817
BLUE SHIELD PROVIDER NUM.
PA
Enumeration date
06/30/2005
Last updated
08/01/2007
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