Provider Demographics
NPI:1841882537
Name:FISHER-NELLIGAN, ALISHA EILEEN
Entity type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:EILEEN
Last Name:FISHER-NELLIGAN
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 1:1621 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:NY
Mailing Address - Zip Code:14065-9719
Mailing Address - Country:US
Mailing Address - Phone:716-523-7066
Mailing Address - Fax:
Practice Address - Street 1:470 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-9455
Practice Address - Country:US
Practice Address - Phone:716-523-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016401-01225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist