Provider Demographics
NPI:1821461567
Name:ARIDA, ALLISON ROSE (NP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ROSE
Last Name:ARIDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-1932
Mailing Address - Country:US
Mailing Address - Phone:716-852-1117
Mailing Address - Fax:716-852-1110
Practice Address - Street 1:1491 SHERIDAN DR
Practice Address - Street 2:SUITE 100
Practice Address - City:TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14217-1234
Practice Address - Country:US
Practice Address - Phone:716-332-4476
Practice Address - Fax:716-332-4479
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF339859363LF0000X
NYF402568-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily