Basic Information
| Provider Information | |||||||||
| NPI: | 1265583983 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHASE-BASSO | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | LYNNE | ||||||||
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| Credential: | MA CCC A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2539 WASHINGTON RD STE 1010 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152412500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249414434 | ||||||||
| FaxNumber: | 7403690812 | ||||||||
| Practice Location | |||||||||
| Address1: | 2539 WASHINGTON RD STE 1010 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152412500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249414434 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2007 | ||||||||
| LastUpdateDate: | 10/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | A01589 | OH | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | AT005947 | PA | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 2095254 | 05 | OH | MEDICAID |