Provider Demographics
NPI:1649600552
Name:KOSIOREK, ALLISON E (DPT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:KOSIOREK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:E
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 1119
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02901-1119
Mailing Address - Country:US
Mailing Address - Phone:401-443-4150
Mailing Address - Fax:
Practice Address - Street 1:1405 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-5081
Practice Address - Country:US
Practice Address - Phone:401-884-1177
Practice Address - Fax:401-884-8697
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPT02655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIU400112013Medicare UPIN