IndividualActive
Alissa Easterly, PTA
NPI 1316685167 · Physical Therapy Assistant · Fayetteville, NY
Provider details
- NPI number
- 1316685167
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- No
- License
- 011832-01 (NY)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
112 Brooklea Dr Apt 1
Fayetteville, NY 13066-1360
Phone: (315) 663-8851
Approximate (ZIP-level) locationGet directions
Mailing address
112 Brooklea Dr Apt 1
Fayetteville, NY 13066-1360
Registry dates
- Enumerated
- 2022-05-23
- Last updated
- 2022-05-23
- Certified
- 2022-05-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.