Healthcare Provider Details

I. General information

NPI: 1871207027
Provider Name (Legal Business Name): ALLISON MCKAY ROOF CM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 08/08/2024
Certification Date: 08/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 BURDETT AVE STE 160
TROY NY
12180-2453
US

IV. Provider business mailing address

PO BOX 14890
ALBANY NY
12212-4890
US

V. Phone/Fax

Practice location:
  • Phone: 518-326-1620
  • Fax: 518-326-1622
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number002243
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: