Provider Demographics
NPI:1861718470
Name:GRAZIANO, ALISON ASHLEY
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:ASHLEY
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 NEWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1603
Mailing Address - Country:US
Mailing Address - Phone:516-826-0103
Mailing Address - Fax:
Practice Address - Street 1:1685 NEWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1603
Practice Address - Country:US
Practice Address - Phone:516-826-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN006506213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery