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Organization

ISMAIL MEDICINE, PLLC

Active
Other names
The Alexandre Centre for Children's Health
Organization subpart
No

Provider details

NPI number
Authorized official
SHAREEN ISMAIL MD (MEDICAL DIRECTOR)
(315) 569-1612
Entity
Organization

Contact information

Practice address
8016 E GENESEE ST, FAYETTEVILLE, NY 13066-9692
(315) 569-1612
Mailing address
8016 E GENESEE ST, FAYETTEVILLE, NY 13066-9692

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
111NP0017X
Pediatric Chiropractor
1223P0221X
Pediatric Dentistry
133VN1004X
Pediatric Nutrition Registered Dietitian
171100000X
Acupuncturist
202D00000X
Integrative Medicine Physician
208000000X
Pediatrics Physician
Primary
2080P0006X
Developmental - Behavioral Pediatrics Physician
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
2080P0216X
Pediatric Rheumatology Physician
2085U0001X
Diagnostic Ultrasound Physician
2251P0200X
Pediatric Physical Therapist
225700000X
Massage Therapist
225XP0200X
Pediatric Occupational Therapist
2278P3900X
Neonatal/Pediatric Certified Respiratory Therapist

Other

Enumeration date
08/28/2024
Last updated
08/28/2024
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