Provider Demographics
NPI:1164415477
Name:FREEMAN, ALLISON L (MD)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:L
Other - Last Name:REDFEARN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1001 MAIN ST FL 4
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1009
Mailing Address - Country:US
Mailing Address - Phone:716-323-0130
Mailing Address - Fax:716-323-0296
Practice Address - Street 1:1001 MAIN ST FL 4
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1009
Practice Address - Country:US
Practice Address - Phone:716-323-0130
Practice Address - Fax:716-323-0296
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4291622080P0201X, 2080P0201X
NY3066042080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06077756Medicaid
PA1017188510002Medicaid
NY06077756Medicaid
NC2221056AMedicare ID - Type Unspecified
NC890256BMedicaid