Provider Demographics
NPI:1356983464
Name:ALMODOVAR, AILYN
Entity type:Individual
Prefix:
First Name:AILYN
Middle Name:
Last Name:ALMODOVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 THEALL RD
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-1406
Mailing Address - Country:US
Mailing Address - Phone:914-925-8275
Mailing Address - Fax:
Practice Address - Street 1:101 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1406
Practice Address - Country:US
Practice Address - Phone:914-925-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-11-27
Deactivation Date:2019-11-16
Deactivation Code:
Reactivation Date:2019-11-27
Provider Licenses
StateLicense IDTaxonomies
NY005914225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant