Provider Demographics
NPI:1003885781
Name:CLAR, ALLISON E (RPAC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:CLAR
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:E
Other - Last Name:BURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 WHITE SPRUCE BLVD
Mailing Address - Street 2:INTERLAKES ONCOLOGY & HEMATOLOGY PC
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-1616
Mailing Address - Country:US
Mailing Address - Phone:585-475-8728
Mailing Address - Fax:585-475-9411
Practice Address - Street 1:1561 LONG POND RD
Practice Address - Street 2:INTERLAKES ONCOLOGY & HEMATOLOGY PC
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4135
Practice Address - Country:US
Practice Address - Phone:585-453-2700
Practice Address - Fax:585-227-1418
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4718363AM0700X
NY004718-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CC4202Medicare ID - Type Unspecified
NYS89755Medicare UPIN