Healthcare Provider Details

I. General information

NPI: 1760519524
Provider Name (Legal Business Name): ELIZABETH W ALLAIRE-LOVE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WESTFALL RD
ROCHESTER NY
14620-4610
US

IV. Provider business mailing address

211 HAWTHORNE CIR
FARMINGTON NY
14425-7039
US

V. Phone/Fax

Practice location:
  • Phone: 585-461-8842
  • Fax: 585-461-8545
Mailing address:
  • Phone: 315-986-4169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0145901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: