MEDICARE: ALLERTON PHYSICAL THERAPY SERVICES, PC

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	261QP2000X	Physical Therapy Clinic/Center	017905	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033377361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERTON PHYSICAL THERAPY SERVICES, PC

Provider Business Mailing Address
First Line	:	2014 WILLIAMSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1603
Country	:	US
Telephone Number	:	718-239-4314
Fax Number	:	718-239-4315

Provider Business Practice Location Address
First Line	:	2014 WILLIAMSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1603
Country	:	US
Telephone Number	:	718-239-4314
Fax Number	:	718-239-4315

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ELIZA DIXON
Credential	:	PT
Telephone Number	:	718-239-4314

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	05/22/2008

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