Individual
AMANDA ALFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, ATC
Contact information
Practice address
42-77 65TH PLACE, WOODSIDE, NY 11377
Mailing address
671 JOHN STREET, TEANECK, NJ 07666
(201) 887-3395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
045282
NY
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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