Provider Demographics
NPI:1962746636
Name:ALTER, RORI MEGAN (DPT)
Entity type:Individual
Prefix:MS
First Name:RORI
Middle Name:MEGAN
Last Name:ALTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1306 AVALON SQ
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2883
Mailing Address - Country:US
Mailing Address - Phone:973-902-2293
Mailing Address - Fax:
Practice Address - Street 1:228 E JERICHO TPKE
Practice Address - Street 2:SIEGE ATHLETICS/PRO REHAB & STRENGTH, LLC
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2034
Practice Address - Country:US
Practice Address - Phone:973-902-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-20
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035362-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist