Provider Demographics
NPI:1467604488
Name:TIBERIO, ALLISON M (RPAC)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:M
Last Name:TIBERIO
Suffix:
Gender:F
Credentials:RPAC
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Mailing Address - Street 1:128 N. HEWLETT AVENUE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566
Mailing Address - Country:US
Mailing Address - Phone:516-378-2870
Mailing Address - Fax:516-378-2295
Practice Address - Street 1:128 N. HEWLETT AVENUE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566
Practice Address - Country:US
Practice Address - Phone:516-378-2870
Practice Address - Fax:516-378-2295
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2015-12-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011102363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant