MEDICARE: MISS RIZA LINA S ALAO 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
1	225100000X	Physical Therapist	015973	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	:	1184646168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RIZA LINA S ALAO PT

Provider Business Mailing Address
First Line	:	82 SHELLY DR
Second Line	:
City	:	BETHPAGE
State	:	NY
Zip	:	11714-5018
Country	:	US
Telephone Number	:	516-731-1335
Fax Number	:

Provider Business Practice Location Address
First Line	:	2111 E 15TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4314
Country	:	US
Telephone Number	:	718-336-9872
Fax Number	:

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	07/08/2007

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