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NPI Code Detail

MEDICARE: ALICIA A EBERSOLE PT

MEDICARE:   ALICIA A EBERSOLE  PT
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
1225100000XPhysical Therapist022762NY

General Provider Information

NPI Number : 1568736551
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA A EBERSOLE PT
Provider Business Mailing Address
First Line : PO BOX 613
Second Line :
City : NUNDA
State : NY
Zip : 14517-0613
Country : US
Telephone Number : 585-519-5050
Fax Number :
Provider Business Practice Location Address
First Line : 25 WEST ST
Second Line :
City : NUNDA
State : NY
Zip : 14517-9685
Country : US
Telephone Number : 585-468-2020
Fax Number : 585-468-5001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2012
Last Update Date : 06/10/2015

Similar Medicare Providers

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1063460061 — DR. NORMAN WETTERAU MD
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1548203516 — GERALD E. TURK NPP-C
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Directions to “ ALICIA A EBERSOLE PT” Practice Location

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