MEDICARE: ALLISON E. CLAR RPAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AM0700X	Medical Physician Assistant	4718	NY
2	363AM0700X	Medical Physician Assistant	004718-1	NY

General Provider Information

NPI Number	:	1003885781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON E. CLAR RPAC

Provider Business Mailing Address
First Line	:	211 WHITE SPRUCE BLVD
Second Line	:	INTERLAKES ONCOLOGY & HEMATOLOGY PC
City	:	ROCHESTER
State	:	NY
Zip	:	14623-1616
Country	:	US
Telephone Number	:	585-475-8728
Fax Number	:	585-475-9411

Provider Business Practice Location Address
First Line	:	1561 LONG POND RD
Second Line	:	INTERLAKES ONCOLOGY & HEMATOLOGY PC
City	:	ROCHESTER
State	:	NY
Zip	:	14626-4135
Country	:	US
Telephone Number	:	585-453-2700
Fax Number	:	585-227-1418

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	03/21/2023

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