Provider Demographics
NPI:1518158328
Name:BELIVEAU, ALYCIA (PT)
Entity Type:Individual
Prefix:
First Name:ALYCIA
Middle Name:
Last Name:BELIVEAU
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 1:2102 RIDGEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-3132
Mailing Address - Country:US
Mailing Address - Phone:401-474-8238
Mailing Address - Fax:
Practice Address - Street 1:524 WARDELL RD
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7305
Practice Address - Country:US
Practice Address - Phone:732-922-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01171800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist