Provider Demographics
NPI:1154504579
Name:ALFONSO, ALREEN DAY LAGMAY (DPT, CIMT, OCS)
Entity Type:Individual
Prefix:
First Name:ALREEN DAY
Middle Name:LAGMAY
Last Name:ALFONSO
Suffix:
Gender:F
Credentials:DPT, CIMT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5840 BANNEKER RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3103
Mailing Address - Country:US
Mailing Address - Phone:410-884-0000
Mailing Address - Fax:410-884-0002
Practice Address - Street 1:5840 BANNEKER RD
Practice Address - Street 2:SUITE 230
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3103
Practice Address - Country:US
Practice Address - Phone:410-884-0000
Practice Address - Fax:410-884-0002
Is Sole Proprietor?:No
Enumeration Date:2007-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0282291225100000X
MD23006225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD512065900Medicaid
NY02951682Medicaid
NYSEIU133823Other1199
NY43103BPOtherHIP
NYQ23912Q021Medicare PIN