Healthcare Provider Details

I. General information

NPI: 1518959568
Provider Name (Legal Business Name): ROBERT E ALESSI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1617 N JAMES ST SUITE 550
ROME NY
13440-2852
US

IV. Provider business mailing address

1617 N JAMES ST SUITE 550
ROME NY
13440-2852
US

V. Phone/Fax

Practice location:
  • Phone: 315-336-3380
  • Fax: 315-339-3182
Mailing address:
  • Phone: 315-336-3380
  • Fax: 315-339-3182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0868571
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: