Healthcare Provider Details

I. General information

NPI: 1447526173
Provider Name (Legal Business Name): ALLISON LINDSAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAWK DR
NEW PALTZ NY
12561-2447
US

IV. Provider business mailing address

2 MILLROCK RD
NEW PALTZ NY
12561-1222
US

V. Phone/Fax

Practice location:
  • Phone: 551-427-0815
  • Fax:
Mailing address:
  • Phone: 551-427-0815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number997
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number12310
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: