Healthcare Provider Details

I. General information

NPI: 1962588194
Provider Name (Legal Business Name): CNY MEDICINE & ALLERGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 TURIN RD BEECHES PROFESSIONAL CAMPUS
ROME NY
13440-1900
US

IV. Provider business mailing address

7900 TURIN RD BEECHES PROFESSIONAL CAMPUS
ROME NY
13440-1900
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 TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BRIAN C ALESSI
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 315-336-3380