Provider Demographics
NPI:1689032971
Name:AVALLONE, STEVEN MICHAEL (PT, DPT)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:AVALLONE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5720 MERTON CT
Mailing Address - Street 2:APARTMENT 271
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-5720
Mailing Address - Country:US
Mailing Address - Phone:631-327-5692
Mailing Address - Fax:
Practice Address - Street 1:2131 O ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1008
Practice Address - Country:US
Practice Address - Phone:631-327-5692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035751225100000X
MA20924225100000X
MD25346225100000X
DCPT871751225100000X
VA2305209125225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist