Provider Demographics
NPI:1245569078
Name:AUSTRIA, ALLELIE TEODORO (RPT)
Entity Type:Individual
Prefix:MRS
First Name:ALLELIE
Middle Name:TEODORO
Last Name:AUSTRIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:ALLELIE
Other - Middle Name:DIGMAN
Other - Last Name:TEODORO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:9812 METROPOLITAN AVE
Mailing Address - Street 2:APT 2FT, FOREST HILLS
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6628
Mailing Address - Country:US
Mailing Address - Phone:347-824-5028
Mailing Address - Fax:
Practice Address - Street 1:236 5TH AVE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7606
Practice Address - Country:US
Practice Address - Phone:347-824-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-07
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030078225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist