Provider Demographics
NPI:1033361308
Name:MESCOLOTTO, ALYSON MICHELLE (DPT)
Entity Type:Individual
Prefix:MS
First Name:ALYSON
Middle Name:MICHELLE
Last Name:MESCOLOTTO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 SMITH ST
Mailing Address - Street 2:APT B1
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3426
Mailing Address - Country:US
Mailing Address - Phone:516-532-0550
Mailing Address - Fax:
Practice Address - Street 1:51 SMITH ST
Practice Address - Street 2:APT B1
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3426
Practice Address - Country:US
Practice Address - Phone:516-532-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-18
Last Update Date:2008-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023709-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics