Individual
ALLYSON WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2212 PENFIELD RD, SUITE 100, PENFIELD, NY 14526-1756
(585) 598-8505
(585) 598-8122
Mailing address
601 ELMWOOD AVE, BOX 278980, ROCHESTER, NY 14642-0001
(585) 598-8505
(585) 598-8122
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
271027
NY
363AM0700X
Medical Physician Assistant
271027
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2010
Last updated
07/07/2023
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