MEDICARE: ALLISON CLAIRE FIELD

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	235Z00000X	Speech-Language Pathologist	02920701	NY

General Provider Information

NPI Number	:	1053873604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON CLAIRE FIELD

Provider Business Mailing Address
First Line	:	47 ELM ST
Second Line	:
City	:	MC GRAW
State	:	NY
Zip	:	13101-9422
Country	:	US
Telephone Number	:	607-745-2882
Fax Number	:

Provider Business Practice Location Address
First Line	:	2809 CINCINNATUS RD
Second Line	:
City	:	CINCINNATUS
State	:	NY
Zip	:	13040-9685
Country	:	US
Telephone Number	:	607-863-3200
Fax Number	:

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

Provider Enumeration Date	:	04/03/2019
Last Update Date	:	10/10/2019

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Directions to “ ALLISON CLAIRE FIELD ” Practice Location

Language	Start Address	Practice Location

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