MEDICARE: ALLA APPLEBAUM P.T.

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	018207	NY

General Provider Information

NPI Number	:	1831332790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLA APPLEBAUM P.T.

Provider Business Mailing Address
First Line	:	318 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4610
Country	:	US
Telephone Number	:	718-627-4244
Fax Number	:

Provider Business Practice Location Address
First Line	:	318 AVENUE M
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4610
Country	:	US
Telephone Number	:	718-627-4244
Fax Number	:

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

Provider Enumeration Date	:	04/08/2009
Last Update Date	:	04/08/2009

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