Provider Demographics
NPI:1508216722
Name:RORIE, ALEXANDER (CRNA)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:RORIE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 AUDLEY WAY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14610-2702
Mailing Address - Country:US
Mailing Address - Phone:136-056-1225
Mailing Address - Fax:
Practice Address - Street 1:20 AUDLEY WAY
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-2702
Practice Address - Country:US
Practice Address - Phone:136-056-1225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-18
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY636577-1163W00000X
NY636577367500000X
WAAP61055260367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse