Provider Demographics
NPI:1770177032
Name:ALFANO, ALISHA
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:ALFANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9360 GOWANDA STATE RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057-9585
Mailing Address - Country:US
Mailing Address - Phone:716-803-4521
Mailing Address - Fax:
Practice Address - Street 1:9360 GOWANDA STATE RD
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:NY
Practice Address - Zip Code:14057-9585
Practice Address - Country:US
Practice Address - Phone:716-803-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula