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General NPI Number Information
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NPI Number | 1619274412
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Entity Type | Individual
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Provider Name | ALISON CLEARY RAUCH RD CDN
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Gender | Female
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Dates
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Enumeration Date | 02/15/2011
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Last Update Date | 02/15/2011
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Provider Practice Location Address
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Address Line | 30 OAKBROOK DR
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City | WEST SENECA
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State | NY
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Zip | 14224-4437
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Country | US
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Telephone | 716-864-8545
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Fax | 716-674-2974
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Provider Business Mailing Address
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Address Line | 30 OAKBROOK DR
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City | WEST SENECA
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State | NY
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Zip | 14224-4437
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Country | US
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Telephone | 716-864-8545
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Fax | 716-674-2974
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 006373
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 876147
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License Number State | NY
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