Individual
ALLIYAH OKHAMVILAYSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3255 ROUTE 39, BLISS, NY 14024-9730
(716) 258-1235
Mailing address
3255 ROUTE 39, BLISS, NY 14024-9730
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
431787
EMT-B
—
Enumeration date
08/07/2017
Last updated
08/07/2017
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