Provider Demographics
NPI:1023570918
Name:MEYER, ALYSSA C (PHARMD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:C
Last Name:MEYER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2784 DUNHAM RD
Mailing Address - Street 2:
Mailing Address - City:VARYSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14167-9736
Mailing Address - Country:US
Mailing Address - Phone:716-949-9240
Mailing Address - Fax:
Practice Address - Street 1:128 N CENTER ST
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:NY
Practice Address - Zip Code:14530-9701
Practice Address - Country:US
Practice Address - Phone:585-237-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY066917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist