Healthcare Provider Details

I. General information

NPI: 1972147411
Provider Name (Legal Business Name): KATHLEEN ALARCON WALLING DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2019
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 MYERS CORNERS RD STE 202
WAPPINGERS FALLS NY
12590-3869
US

IV. Provider business mailing address

167 MYERS CORNERS RD STE 202
WAPPINGERS FALLS NY
12590-3869
US

V. Phone/Fax

Practice location:
  • Phone: 845-485-9803
  • Fax:
Mailing address:
  • Phone: 845-485-9803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number051607
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: