Provider Demographics
NPI:1982634598
Name:HANDY, ALYSON W (RPA-C)
Entity Type:Individual
Prefix:
First Name:ALYSON
Middle Name:W
Last Name:HANDY
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 RIDGEWAY AVENUE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14646-4145
Mailing Address - Country:US
Mailing Address - Phone:585-720-1550
Mailing Address - Fax:585-720-1553
Practice Address - Street 1:2440 RIDGEWAY AVENUE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14646-4145
Practice Address - Country:US
Practice Address - Phone:585-720-1550
Practice Address - Fax:585-720-1553
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004620363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02506852Medicaid
NYPA0463OtherPREFERRED CARE
NYP019004620OtherBLUE CHOICE
NYPA1033Medicare ID - Type Unspecified
NYPA0463OtherPREFERRED CARE