Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 023709-1 | NY |
NPI | 1033361308 |
---|---|
Provider Name | Ms. Alyson Michelle Mescolotto |
First Address | Merrick, NY 11566-3426 |
Second Address | Merrick, NY 11566-3426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2008 |
Last Update Date | 18/10/2008 |