1477032928 NPI number — ALYSSA CATHRYN SETTELMAIER DPT, CLT

Table of content: ALYSSA CATHRYN SETTELMAIER DPT, CLT (NPI 1477032928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477032928 NPI number — ALYSSA CATHRYN SETTELMAIER DPT, CLT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SETTELMAIER
Provider First Name:
ALYSSA
Provider Middle Name:
CATHRYN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT, CLT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROUGH
Provider Other First Name:
ALYSSA
Provider Other Middle Name:
CATHRYN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT, CLT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477032928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 S MAIN ST
Provider Second Line Business Mailing Address:
STE 220
Provider Business Mailing Address City Name:
JAMESTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14701-6626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-488-2322
Provider Business Mailing Address Fax Number:
716-488-2574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 S MAIN ST
Provider Second Line Business Practice Location Address:
STE 220
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14701-6626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-488-2322
Provider Business Practice Location Address Fax Number:
716-488-2574
Provider Enumeration Date:
08/07/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  045465 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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