Individual
GIA M AVALLONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4170 CITY AVE, PHILADELPHIA, PA 19131-1610
(215) 871-6700
Mailing address
4170 CITY AVE, PHILADELPHIA, PA 19131-1610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
390200000X
—
Other
Enumeration date
02/18/2020
Last updated
03/16/2021
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