Basic Information
| Provider Information | |||||||||
| NPI: | 1821461567 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARIDA | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | ROSE | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 254 FRANKLIN ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142021932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168521117 | ||||||||
| FaxNumber: | 7168521110 | ||||||||
| Practice Location | |||||||||
| Address1: | 1491 SHERIDAN DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TONAWANDA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142171234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7163324476 | ||||||||
| FaxNumber: | 7163324479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2015 | ||||||||
| LastUpdateDate: | 04/16/2019 | ||||||||
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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 | 363LF0000X | F339859 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | F402568-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.