Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 307227 | NY |
N | 207V00000X | Obstetrician & Gynecologist | MT205097 | PA |
Y | 207VX0201X | Gynecologic Oncologist | 307227 | NY |
N | 207VX0201X | Gynecologic Oncologist | MD460665 | PA |
NPI | 1245678291 |
---|---|
Provider Name | Allison Grace Roy |
First Address | Syracuse, NY 13212-4516 |
Second Address | Syracuse, NY 13210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 05/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02670804 | (05) | NY |