Provider Demographics
NPI:1093497612
Name:LORICH, ALYCE M
Entity Type:Individual
Prefix:
First Name:ALYCE
Middle Name:M
Last Name:LORICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 TRANSIT RD STE 119-121
Mailing Address - Street 2:
Mailing Address - City:ELMA
Mailing Address - State:NY
Mailing Address - Zip Code:14059-9041
Mailing Address - Country:US
Mailing Address - Phone:716-626-2222
Mailing Address - Fax:716-626-2220
Practice Address - Street 1:2711 TRANSIT RD STE 119-121
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:NY
Practice Address - Zip Code:14059-9041
Practice Address - Country:US
Practice Address - Phone:716-626-2222
Practice Address - Fax:716-626-2220
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator