Basic Information
| Provider Information | |||||||||
| NPI: | 1235211384 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALLERTON | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | MAUREEN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | RPAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 SOUTH AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146202733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853418485 | ||||||||
| FaxNumber: | 5853418326 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 RED CREEK DR | ||||||||
| Address2: | 120 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146234273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853345580 | ||||||||
| FaxNumber: | 5853345581 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 03/06/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 005553 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.