Provider Demographics
NPI:1407425903
Name:DWYER, ALLISON M (DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:DWYER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 HOMECROFT RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-3039
Mailing Address - Country:US
Mailing Address - Phone:315-380-6360
Mailing Address - Fax:
Practice Address - Street 1:5460 MELTZER CT
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039-9430
Practice Address - Country:US
Practice Address - Phone:315-699-1619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation