Healthcare Provider Details

I. General information

NPI: 1568497006
Provider Name (Legal Business Name): ALINA KRISHNAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/19/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 W GARDEN ST SUITE 201
AUBURN NY
13021-2662
US

IV. Provider business mailing address

620 WESTFALL RD SUITE 201
ROCHESTER NY
14620-4610
US

V. Phone/Fax

Practice location:
  • Phone: 315-253-6257
  • Fax: 315-253-8693
Mailing address:
  • Phone: 585-461-8589
  • Fax: 585-461-8580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number237951
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: