Provider Demographics
NPI:1598952830
Name:ROTHSTEIN, ALLISON P (PT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:P
Last Name:ROTHSTEIN
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 1:709 HAWKINS AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:LAKE RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-2293
Mailing Address - Country:US
Mailing Address - Phone:631-467-4221
Mailing Address - Fax:631-422-3723
Practice Address - Street 1:709 HAWKINS AVE STE 1
Practice Address - Street 2:
Practice Address - City:LAKE RONKONKOMA
Practice Address - State:NY
Practice Address - Zip Code:11779-2293
Practice Address - Country:US
Practice Address - Phone:631-467-4221
Practice Address - Fax:631-422-3723
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0286361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist