Individual
ILENE ALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4575 MAIN ST, AMHERST, NY 14226-4567
(716) 633-4575
(716) 633-4576
Mailing address
4575 MAIN ST, AMHERST, NY 14226-4567
(716) 633-4575
(716) 633-4576
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
F360040
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00021042303
UNIVERA
NY
01
—
000560305006
BC/BS
NY
05
—
02343451
—
NY
01
—
9511820
IHA
NY
Enumeration date
01/04/2006
Last updated
04/29/2011
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