Healthcare Provider Details

I. General information

NPI: 1891672937
Provider Name (Legal Business Name): ALLISON REOME
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 FALCON TRACE DR APT E
HALFMOON NY
12065-4603
US

IV. Provider business mailing address

7 FALCON TRACE DR APT E
HALFMOON NY
12065-4603
US

V. Phone/Fax

Practice location:
  • Phone: 760-818-2234
  • Fax:
Mailing address:
  • Phone: 760-818-2234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number073062
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: