Provider Demographics
NPI:1275618613
Name:KAISER, ALICIA GLASSO (PT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:GLASSO
Last Name:KAISER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 CORPORATE DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-7004
Mailing Address - Country:US
Mailing Address - Phone:412-369-7735
Mailing Address - Fax:412-369-7667
Practice Address - Street 1:5900 CORPORATE DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-7004
Practice Address - Country:US
Practice Address - Phone:412-369-7735
Practice Address - Fax:412-369-7667
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT002517E2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA094146Medicare ID - Type Unspecified