Provider Demographics
NPI:1477221067
Name:MARKS BRUNSON, ALISON (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:MARKS BRUNSON
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:PELLETTIERI MARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1801 N PEARL ST APT 1402
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2957
Mailing Address - Country:US
Mailing Address - Phone:224-280-5874
Mailing Address - Fax:
Practice Address - Street 1:550 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-1634
Practice Address - Country:US
Practice Address - Phone:914-777-3737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist