Provider Demographics
NPI:1437254331
Name:FORD, ALLISON M (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:M
Last Name:FORD
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 888
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-3937
Mailing Address - Fax:
Practice Address - Street 1:500 S.CLINTON AVE.
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620
Practice Address - Country:US
Practice Address - Phone:585-273-3937
Practice Address - Fax:585-276-0324
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006284152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU81966Medicare UPIN
NY0837970001Medicare NSC
NYCC9307Medicare ID - Type Unspecified