Provider Demographics
NPI:1609021807
Name:DOYLE, TAMI ALEXIS (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:TAMI
Middle Name:ALEXIS
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LT BRENDER HWY
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:NY
Mailing Address - Zip Code:12734-5403
Mailing Address - Country:US
Mailing Address - Phone:845-292-3427
Mailing Address - Fax:
Practice Address - Street 1:301 LT BRENDER HWY
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:NY
Practice Address - Zip Code:12734-5403
Practice Address - Country:US
Practice Address - Phone:845-292-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0138542251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics