Provider Demographics
NPI:1548604093
Name:O'BRIEN, ALISON (DO)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:60 GREECE CENTER DR STE 4
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-1358
Mailing Address - Country:US
Mailing Address - Phone:585-602-0100
Mailing Address - Fax:585-453-9240
Practice Address - Street 1:60 GREECE CENTER DR STE 4
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-1358
Practice Address - Country:US
Practice Address - Phone:585-602-0100
Practice Address - Fax:585-453-9240
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY287391208000000X, 208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04797600Medicaid