Provider Demographics
NPI:1619274412
Name:RAUCH, ALISON CLEARY (RD CDN)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:CLEARY
Last Name:RAUCH
Suffix:
Gender:F
Credentials:RD CDN
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:CLEARY
Other - Last Name:KRESSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:30 OAKBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-4437
Mailing Address - Country:US
Mailing Address - Phone:716-864-8545
Mailing Address - Fax:716-674-2974
Practice Address - Street 1:30 OAKBROOK DR
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-4437
Practice Address - Country:US
Practice Address - Phone:716-864-8545
Practice Address - Fax:716-674-2974
Is Sole Proprietor?:No
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006373133N00000X
NY876147133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist