MEDICARE: MARY ALPHONSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305217711	VA

General Provider Information

NPI Number	:	1437005543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ALPHONSE

Provider Business Mailing Address
First Line	:	PO BOX 392573
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-1661
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8316 ARLINGTON BLVD STE 640
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-5216
Country	:	US
Telephone Number	:	703-272-8340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	05/26/2026

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Directions to “ MARY ALPHONSE ” Practice Location

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