Provider Demographics
NPI:1023495561
Name:LALL, ALISHA (MD)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:LALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:565 ABBOTT RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2039
Mailing Address - Country:US
Mailing Address - Phone:716-828-2434
Mailing Address - Fax:716-828-3417
Practice Address - Street 1:725 ORCHARD PARK RD STE A
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3352
Practice Address - Country:US
Practice Address - Phone:716-675-1001
Practice Address - Fax:716-675-3832
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2020-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY295498207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine