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NPI Code Detail

MEDICARE: ALANNA M RANDALL M.S.

MEDICARE: ALANNA M RANDALL M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist012314-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130-0213081OTHERNYTAX ID

General Provider Information

NPI Number : 1730273723
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALANNA M RANDALL M.S.
Provider Business Mailing Address
First Line : 38 W CHURCH ST
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-2130
Country : US
Telephone Number : 585-421-2015
Fax Number : 585-421-2024
Provider Business Practice Location Address
First Line : 38 W CHURCH ST
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-2130
Country : US
Telephone Number : 585-421-2015
Fax Number : 585-421-2024
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 06/18/2015

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Directions to “ ALANNA M RANDALL M.S.” Practice Location

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