Provider Demographics
NPI:1740645118
Name:CANALE, ALICE (MSPT)
Entity type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:CANALE
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WILLIAM ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-1903
Mailing Address - Country:US
Mailing Address - Phone:914-328-3750
Mailing Address - Fax:914-328-6945
Practice Address - Street 1:2 WILLIAM ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1909
Practice Address - Country:US
Practice Address - Phone:914-328-3750
Practice Address - Fax:914-328-6945
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024337225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist