Provider Demographics
NPI:1215025838
Name:SILES, ALAN (PT)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:
Last Name:SILES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 STONELEIGH AVE
Mailing Address - Street 2:S-112
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-2454
Mailing Address - Country:US
Mailing Address - Phone:845-279-4110
Mailing Address - Fax:845-279-9432
Practice Address - Street 1:667 STONELEIGH AVE
Practice Address - Street 2:S-112
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2454
Practice Address - Country:US
Practice Address - Phone:845-279-4110
Practice Address - Fax:845-279-9432
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002423225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ51851Medicare ID - Type UnspecifiedPHYSICAL THERAPIST