Amanda Alfonso, PT, DPT, ATC
Individual provider Active NPI Physical Therapist · Woodside, NY
NPI 1104466465 · NPPES record last updated Jan 14, 2020
Key facts
- NPI
- 1104466465
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 045282 (NY)
- Practice address
- 42-77 65TH Place
Woodside, NY 11377 - NPI assigned
- Jan 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 045282 | NY | Yes |
Addresses
Primary practice location
42-77 65TH Place
Woodside, NY 11377
Mailing address
671 John Street
Teaneck, NJ 07666
Phone (201) 887-3395
Other providers in Woodside, NY
- Aka Medical Wellness and Aesthetics LLC
- Ayesha Akhter
- Layla K Alaouie
- Alavi-Lin Dental PC
- Aldea, Inc.
- Lucha Alforque
- Aleem Anthony Ali
- Amy Gabriel Alken
- All American Social Adult Daycare Inc.
- Almaz Med Supply Inc
All providers in Woodside, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.