Provider Demographics
NPI:1831881747
Name:GREENE, ALISON MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIE
Last Name:GREENE
Suffix:
Gender:F
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 1:734 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:13668-3157
Mailing Address - Country:US
Mailing Address - Phone:315-842-2887
Mailing Address - Fax:
Practice Address - Street 1:205 STATE STREET RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-3302
Practice Address - Country:US
Practice Address - Phone:315-386-4541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049752-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist