Provider Demographics
NPI:1518235985
Name:CHAMBRE, ALISSA (MPT)
Entity Type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:
Last Name:CHAMBRE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13710 68TH DR
Mailing Address - Street 2:APT A
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1622
Mailing Address - Country:US
Mailing Address - Phone:917-864-2368
Mailing Address - Fax:
Practice Address - Street 1:13710 68TH DR
Practice Address - Street 2:APT A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1622
Practice Address - Country:US
Practice Address - Phone:917-864-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030695-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist