MEDICARE: MRS. ALICIA P DWYER PT, DPT

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	07862	LA

General Provider Information

NPI Number	:	1003136359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA P DWYER PT, DPT

Provider Business Mailing Address
First Line	:	169 MADISON AVE STE 15501
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-5101
Country	:	US
Telephone Number	:	385-308-8034
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 VETERANS BLVD
Second Line	:	SUITE A
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-4726
Country	:	US
Telephone Number	:	225-667-6598
Fax Number	:	225-664-8167

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

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	07/23/2025

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