Provider Demographics
NPI:1750051421
Name:ROYCE, ALLYSON ELAINE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:ELAINE
Last Name:ROYCE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:ELAINE
Other - Last Name:ROYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4989 GENESEE ST APT 413
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14225-5572
Mailing Address - Country:US
Mailing Address - Phone:585-689-1567
Mailing Address - Fax:
Practice Address - Street 1:777 MARYVALE DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2712
Practice Address - Country:US
Practice Address - Phone:716-631-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist