Provider Demographics
NPI:1881105468
Name:GOLIA, ALLISON
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:
Last Name:GOLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 EDGEHILL DR
Mailing Address - Street 2:
Mailing Address - City:FURLONG
Mailing Address - State:PA
Mailing Address - Zip Code:18925-1101
Mailing Address - Country:US
Mailing Address - Phone:215-872-1182
Mailing Address - Fax:
Practice Address - Street 1:210 CENTRAL PARK S STE 1A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1430
Practice Address - Country:US
Practice Address - Phone:212-837-1946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA004928363A00000X
PAMA060884363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant