Healthcare Provider Details

I. General information

NPI: 1255880589
Provider Name (Legal Business Name): ALISON HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2016
Last Update Date: 06/29/2023
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 ELMWOOD AVE
ROCHESTER NY
14642-4322
US

IV. Provider business mailing address

206 CHAPIN ST
CANANDAIGUA NY
14424-1606
US

V. Phone/Fax

Practice location:
  • Phone: 585-275-2142
  • Fax:
Mailing address:
  • Phone: 585-733-4146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number114832
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN659829
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number248585
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number752309
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: