Provider Demographics
NPI:1295319499
Name:FREIER, ALLEGRA GABRIELLE (LMT)
Entity type:Individual
Prefix:MS
First Name:ALLEGRA
Middle Name:GABRIELLE
Last Name:FREIER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 MILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14170-9712
Mailing Address - Country:US
Mailing Address - Phone:716-544-5766
Mailing Address - Fax:
Practice Address - Street 1:989 KENMORE AVE
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2924
Practice Address - Country:US
Practice Address - Phone:716-544-5766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032090225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist