Basic Information
| Provider Information | |||||||||
| NPI: | 1336572957 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALLEY | ||||||||
| FirstName: | ROLAND | ||||||||
| MiddleName: | RICHARD | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95 UNIVERSITY PL | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100034515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126041316 | ||||||||
| FaxNumber: | 6462918025 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 UNIVERSITY PL | ||||||||
| Address2: | 8TH FLOOR | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100034515 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126041316 | ||||||||
| FaxNumber: | 6462918025 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2013 | ||||||||
| LastUpdateDate: | 08/19/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 036432 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.