Provider Demographics
NPI:1497463111
Name:SEILHEIMER, ALLYSSA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:ALLYSSA
Middle Name:MARIE
Last Name:SEILHEIMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 PARRISH ST # 3B-35
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1724
Mailing Address - Country:US
Mailing Address - Phone:595-732-4048
Mailing Address - Fax:
Practice Address - Street 1:190 PARRISH ST # 3B-35
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1724
Practice Address - Country:US
Practice Address - Phone:595-732-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345323164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty