MEDICARE: ALISSA WHITE PHARMD

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	183500000X	Pharmacist	I068693-01	NY

General Provider Information

NPI Number	:	1851052898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISSA WHITE PHARMD

Provider Business Mailing Address
First Line	:	775 WASHINGTON ST
Second Line	:
City	:	SPENCERPORT
State	:	NY
Zip	:	14559-9703
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 CORNELIA ST
Second Line	:
City	:	PLATTSBURGH
State	:	NY
Zip	:	12901-2308
Country	:	US
Telephone Number	:	518-314-6487
Fax Number	:

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

Provider Enumeration Date	:	01/03/2022
Last Update Date	:	01/06/2022

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Directions to “ ALISSA WHITE PHARMD” Practice Location

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