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Individual

DR. ALLEN ROACH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1357 MONROE AVE, ROCHESTER, NY 14618-1005
(585) 442-9601
(585) 442-9606
Mailing address
1357 MONROE AVE, ROCHESTER, NY 14618-1005
(585) 442-9601
(585) 442-9606

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
006084
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0005103143
AETNA PROVIDER #
NY
01
100204FC
PREFERRED CARE PROVIDER #
NY
Enumeration date
05/23/2006
Last updated
07/08/2007
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